In Reply.—We thank Dr Modica for his comments and appreciate the opportunity to respond. There seem to be some matters that require clarification. First of all, we would like to stress the fact that Candida colonization is not limited to the Groningen button voice prosthesis, but can be observed on all voice prostheses that are made of silicone material.1-3 Dr Modica suggests the removal and cleansing of a prosthesis once or twice weekly to prevent fungal colonization. We, however, doubt the effectiveness of such a procedure, because a recent article2 mentions fungal growth on prostheses as early as one day following placement! The same article confirms our experience that once the fungi have adhered to the silicone it is almost impossible to remove them without damaging the silicone material itself.
A voice prosthesis can be easily damaged by an overly thorough cleaning procedure, especially when a lowpressure
MAHIEU HF, VAN SAENE HKF. Care of Tracheoesophageal Voice Prostheses-Reply. Arch Otolaryngol Head Neck Surg. 1987;113(4):437. doi:10.1001/archotol.1987.01860040098030
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