The artificial throat: a new method for standardization of in vitro experiments with tracheo-oesophageal voice prostheses.

After total laryngectomy, the voice can be restored successfully with a silicone tracheo-oesophageal voice prosthesis. Biofilm formation and subsequent deterioration of the silicone material of the prosthesis often limit the mean life of the device to an average of 3-5 months. Although device replacement can be considered an easy outpatient procedure, frequent replacements are inconvenient for the patient and may lead to malfunction of the tracheo-oesophageal fistula. Further understanding of the process of development and inhibition of the colonization of these polymer surfaces requires several comprehensive clinical studies. However, in vivo research of the biomaterials of the voice prostheses is difficult and time consuming. In order to simulate the natural process of biofilm development under dynamic nutrient conditions, an artificial throat was developed. Biofilm developed on Groningen button voice prostheses in vitro could not be distinguished from that formed over several months in vivo. This method can be used as a standardized approach for studying functional and structural aspects of all commercially available indwelling and non-indwelling voice prostheses, including the Groningen button, Provox, Voice Master, Blom-Singer and others under various laboratory conditions.