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Letter to the Editor
In reference to Voice rehabilitation with voice prosthesis: Long-term results, complications, and risk factors
Con referencia a Rehabilitación de la voz con prótesis fonatorias: resultados a largo plazo, complicaciones y factores de riesgo
Miguel Mayo-Yáñeza,b,
Corresponding author
miguel.mayo.yanez@sergas.es

Corresponding author.
, Irma Cabo-Varelaa
a Otorhinolaryngology – Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
b Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have read the article entitled &#8220;<span class="elsevierStyleItalic">Voice rehabilitation with voice prosthesis&#58; Long term results&#44; complications and risk</span><span class="elsevierStyleItalic">factors</span>&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> We acknowledge the authors for the voice prosthesis &#40;VP&#41; study carried out&#46; The improvement of VP has not been accompanied by an increase in its duration&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> so studies of this type continue to be necessary&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#8211;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">First&#44; the results obtained regarding the duration of the VP are noteworthy &#40;&#62;7 months&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> These results are far from those obtained by other authors &#40;2&#8211;3 months&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#44;4</span></a> some of which are cited in the article itself&#44; and being more similar to data obtained in studies with methodological biases&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> It would be interesting to know which type of Provox is used&#44; since large statistically significant differences have been shown between one generation and another and that information is missing in the methodology&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4&#44;5</span></a> What is this favorable data due to according to the authors&#63;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Second&#44; apart from individual predisposition&#44; various factors that could influence the duration of the VP have been discussed in the literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#8211;4</span></a> A direct correlation between the incidence of severe fistula enlargement and reflux disease&#44; confirmed by impedance-pH monitoring&#44; has been demonstrated in several studies&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> The prophylactic treatment with proton pump inhibitors<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>alginate may be justified in patients with substantial fistula enlargement&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> This study lacks a detailed explanation in its methodology about the evaluation of a possible reflux or the presence of anti-reflux therapeutic measures&#44; being able to represent a source of biases&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Third&#44; regarding the statistical analysis&#44; a multiple linear regression does not seem to be indicated in this type of study&#46; In the discussion&#44; this fact is directly specified with the sentence &#8220;<span class="elsevierStyleItalic">the longer the patients are followed&#44; the greater number of replacements are</span><span class="elsevierStyleItalic">made</span>&#8221;&#44; being one of the main conclusions of the study&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It seems logical&#46; In the study of VP replacements&#44; it is more interesting to conduct a Kaplan&#8211;Meier curves or proportional hazards regression model with the replacement of the VP as the event of interest&#44; to assess the effect of the different variables and control the effect of time&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Finally&#44; the management of laryngectomized patients and of voice prosthesis users is complex and requires a multidisciplinary care &#40;otolaryngologists and speech therapists&#41; by professionals with experience in the field in order to reduce replacements and complications&#44;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#44;3</span></a> so it would be interesting to clarify what kind of systematic approach has been used&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">There was no conflict of interest and authors have nothing to declare&#46; This research does not involve human participants and was approved by the Hospital&#39;s Ethics Committee&#46;</p></span></span>"
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Article information
ISSN: 00016519
Original language: English
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos