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Long-term outcomes and cost-effectiveness of a magnet-based valve voice prosthesis for endoprosthesis leakage treatment

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Abstract

Purpose

Tracheoesophageal speech is considered the gold standard for rehabilitation following total laryngectomy. The main reason of voice prosthesis failure is the endoprosthesis leakage. Provox ActiValve® incorporates a magnet-based valve system to achieve active closure of the valve to treat these leakages, with the drawback of being significantly more expensive. The aim of the study was to compare the Provox Vega® and Provox ActiValve® duration and costs in patients with replacements increase due to endoprosthetic leakage.

Methods

Prospective case-crossover study in laryngectomized patients with Provox Vega® and endoprosthesis leakage to whom a Provox ActiValve® was placed. Survival and possible factors that affect voice prosthesis were studied using Kaplan–Meier curves and Cox Proportional Hazards Regression. Cost-effectiveness analysis from the perspective of the Spanish Public National Health System with incremental cost-effectiveness calculation was performed.

Results

A total of 159 prostheses were evaluated. The most frequent reason for replacement was the endoprosthesis leakage (N = 129; 83.77%) in both models. The mean duration-time of Provox Vega® was 44.77 ± 2.82 days (CI 95%, 39.18–50.35; median 36 days), and 317.34 ± 116.8 days (CI 95% 86.66–548; median 286 days) for the Provox ActiValve® (p < 0.000). For every replacement not made thanks to the Provox ActiValve® there was saving of 133.97€

Conclusions

The Provox ActiValve® is a cost-effective solution in patients with increased prosthesis replacements due to endoprosthetic leakage, reducing the number of changes and cost compared to Provox Vega®.

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Authors and Affiliations

  1. Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), As Xubias 84, 15006, A Coruña, Galicia, Spain

    Miguel Mayo-Yáñez & Irma Cabo-Varela

  2. Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Universidade de Santiago de Compostela (USC), 15782, Santiago de Compostela, Galicia, Spain

    Miguel Mayo-Yáñez & Christian Calvo-Henríquez

  3. Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France

    Miguel Mayo-Yáñez, Carlos Chiesa-Estomba, Jérôme R. Lechien, Christian Calvo-Henríquez & Luigi A. Vaira

  4. Otorhinolaryngology-Head and Neck Surgery Department, Hospital Universitario Donostia, 20014, Donostia, Euskadi, Spain

    Carlos Chiesa-Estomba

  5. Otolaryngology Department, Elsan Hospital, Paris, France

    Jérôme R. Lechien

  6. Otorhinolaryngology and Head and Neck Surgery Department, Foch Hospital, Paris Saclay University, Paris, France

    Jérôme R. Lechien

  7. Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario Santiago de Compostela (CHUS), 15706, Santiago de Compostela, Galicia, Spain

    Christian Calvo-Henríquez

  8. Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy

    Luigi A. Vaira

Authors
  1. Miguel Mayo-Yáñez
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  2. Carlos Chiesa-Estomba
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  6. Irma Cabo-Varela
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Correspondence to Miguel Mayo-Yáñez.

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Mayo-Yáñez, M., Chiesa-Estomba, C., Lechien, J.R. et al. Long-term outcomes and cost-effectiveness of a magnet-based valve voice prosthesis for endoprosthesis leakage treatment. Eur Arch Otorhinolaryngol 279, 4167–4172 (2022). https://doi.org/10.1007/s00405-022-07313-x

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  • DOI: https://doi.org/10.1007/s00405-022-07313-x

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