NCT04268459

Brief Summary

The tracheoesophageal voice with voice prosthesis is currently the mainstay of voice rehabilitation post laryngectomy. The primary surgical technique of tracheoesophageal fistula formation with insertion of prosthesis and quick and easy process of voice rehabilitation are main encouraging factors. However, the usage of the prosthesis relates to a significant number of complications rated from 10 to 60%. The most common reported complication is transprosthetic leakage that determines the need of device exchange. However in some patients occur more serious complications eg. periprosthetic leakage, granulation or atrophy of mucosa around the fistula, dislocation of prosthesis, that may require anti-inflammatory treatment, temporary nasogastric tube feeding or surgical procedure. The standard protocol is voice prosthesis exchange due to transprosthetic leakage. Optionally the device could be replaced regularly to prevent both transprosthetic leakage and other complication occurrence. In the study we plan to compare the benefits from regular (each three month) versus leakage-related exchange of voice prosthesis post laryngectomy including the rate of complications, fistula colonization by Candida species and patients feedback.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
70

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Mar 2020

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 10, 2020

Completed
3 days until next milestone

First Posted

Study publicly available on registry

February 13, 2020

Completed
26 days until next milestone

Study Start

First participant enrolled

March 10, 2020

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 10, 2021

Completed
1.1 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 31, 2022

Completed
Last Updated

February 13, 2020

Status Verified

February 1, 2020

Enrollment Period

1 year

First QC Date

February 10, 2020

Last Update Submit

February 10, 2020

Conditions

Keywords

voice prosthesis, laryngectomy, complications

Outcome Measures

Primary Outcomes (1)

  • Comparison of complications rate.

    In both arms of the study we will compare the incidence of following complications: periprosthetic leakage, granulation or atrophy of mucosa around the fistula, dislocation of prosthesis

    Control will be continued for 12 months post laryngectomy.

Secondary Outcomes (2)

  • Fistula colonization with Candida species.

    Control will be continued for 12 months post laryngectomy.

  • Prosthesis replacement scheme and patient satisfaction.

    Control will be continued for 12 months post laryngectomy.

Study Arms (2)

Regular exchange

ACTIVE COMPARATOR

Patients will be appointed each 3 months for regular exchange of voice prosthesis.

Device: Provox prosthesis exchange

Leakage exchange

ACTIVE COMPARATOR

Patients will have voice prosthesis exchange when leakage occurs.

Device: Provox prosthesis exchange

Interventions

Each patient post laryngectomy will be randomly assigned to one arm of intervention. The voice prosthesis exchange in all patients will be performed in local anaesthesia. The microbiological samples with cotton swabs will be collected from tracheoesophageal fistula on prosthesis exchange. The clinical evaluation and patients satisfaction from prosthesis usage will be performed on each exchange.

Leakage exchangeRegular exchange

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • patients post laryngectomy with primary insertion of voice prosthesis

You may not qualify if:

  • patients post laryngopharyngectomy with digestive tract reconstruction with jejunum of free flap

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department of Otorhinolaryngology, Head andNeck Surgery of Medical University of Warsaw

Warsaw, 02-097, Poland

Location

Related Publications (2)

  • Zurek M, Czesak M, Majszyk D, Rzepakowska A. Benefit from regular versus leakage-related exchange of voice prostheses in patients post-laryngectomy considering complication rates and patient satisfaction feedback-a randomized case-controlled trial. Front Oncol. 2025 Jan 24;15:1468955. doi: 10.3389/fonc.2025.1468955. eCollection 2025.

  • Zurek M, Czesak M, Czerwinska ME, Berezovska D, Niemczyk K, Rzepakowska A. A double-blind randomized clinical trial of inflammatory cytokine and pepsin levels in the saliva of patients with voice prostheses. Head Neck. 2024 Sep;46(9):2116-2122. doi: 10.1002/hed.27847. Epub 2024 Jun 12.

MeSH Terms

Conditions

Prosthesis Failure

Condition Hierarchy (Ancestors)

Postoperative ComplicationsPathologic ProcessesPathological Conditions, Signs and Symptoms

Study Officials

  • Anna Rzepakowska, PhD

    Medical University of Warsaw

    STUDY CHAIR

Central Study Contacts

Anna Rzepakowska, PhD

CONTACT

Daniel Majszyk, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Model Details: randomized controlled trial
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD, PhD

Study Record Dates

First Submitted

February 10, 2020

First Posted

February 13, 2020

Study Start

March 10, 2020

Primary Completion

March 10, 2021

Study Completion

March 31, 2022

Last Updated

February 13, 2020

Record last verified: 2020-02

Data Sharing

IPD Sharing
Will share
Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR
Time Frame
Date will become available from April 2022 until April 2023.
Access Criteria
on request

Locations