Multimodal imaging reveals surface degradation of voice prosthesis implants resulting from colonisation by polymicrobial biofilms

Total laryngectomy is a surgical procedure for advanced laryngeal and hypopharyngeal cancers. After the surgery, voice prosthesis (VP) implants are commonly used to help patients regain speech. However, these implants can fail early due to the formation and invasion of biofilms on their surface. Routine nystatin usage and frequent valve changes are often necessary.

Despite these complications, the specific bacteria and fungi responsible for this failure are not well understood. To address this, researchers have created a quick method to process explanted VP implants collected from patients within 90 minutes. By using a combination of reflection contrast and fluorescence confocal laser scanning microscopy, they were able to visualize the VP surface and observe the biofilms in real-time, revealing new information about the impact of these pathogens on VP failure.

The research shows that complex fungal and bacterial biofilms form on the VP surface and can even penetrate the device, causing silicone particles to break off and become trapped within the biofilm. These findings emphasize the need for more advanced treatment strategies compared to the standard approach, as well as the importance of considering patient factors and the unique material properties of the valve.