To the Editor.—We readily accept the criticism of your reviewers regarding our definition of "success" in our recent article.1 We agree that follow-up at one year would be more useful in assessing patient compliance, and we are now in a position to provide this information on the original series of 36 patients.
As described in the article, there were four (11%) failures within the first 3 months. Subsequently, four (11%) further patients ceased using their valve as their chosen mode of communication within the first year. One of these patients disliked fingering the stoma and abandoned the prosthesis in favor of esophageal speech. A second patient developed a stricture at the level of the tracheoesophageal puncture that resulted in the prosthesis being difficult to maintain and, eventually, the patient adopted the use of an artificial larynx. In the remaining two "late failures" the prosthesis was extruded and the
MILFORD CA, PERRY AR, CHEESMAN AD. Surgical Voice Restoration. Arch Otolaryngol Head Neck Surg. 1989;115(11):1388–1389. doi:10.1001/archotol.1989.01860350122030
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