Provox ActiValve is a voice prosthesis specially developed for a sub-group of patients with a much shorter than average device life (see also Troubleshooting - very frequent replacement ....). This short device life is not only caused by excessive and early biofilm formation, but also because of an under-pressure in the oesophagus during breathing and swalowing, which opens the valve regularly. The biofilm problem is addressed by the use of teflon-like material for valve and valve seat, and the under-pressure issue by incorporating magnets, which counteract this and cause an active closure of the valve (see pictures to the right). This has resulted in a voice prosthesis which shows a significantly longer device life than the regular Provox devices.1 To the right a voice prosthesis can be seen that was in situ for one year in a patient, who required a replacement of the Provox2 every 3 weeks. In a recent long term study, in a patient cohort with a median device life of 21 days, the ActiValve prosthesis had a median device life of 337 days, whcih means a 16 fold increase (p<0.001; survival curves to the right).2 In a recent study in the USA similar median device life was found for ActiValve, making this a very cost-effective solution for patients, who require frequent replacements.3
References:1. Hilgers FJM, Ackerstaff AH, Balm AJM, van den Brekel MWM, Tan IB, Persson JO. A new problem-solving indwelling voice prosthesis, eliminating frequent candida- and ‘under-pressure’-related replacements: Provox ActiValve. Acta Otolaryngol (Stockh) 2003; 123: 972-979.2. Soolsma J, van den Brekel MWM, Ackerstaff AH, Balm AJM, Tan IB, Hilgers FJM. Long-term results of Provox ActiValve, solving the problem of frequent Candida- and ‘underpressure’-related voice prosthesis replacements. Laryngoscope 2008; 118: 252-257.3. Graville DJ, Palmer AD, Andersen PE, Cohen JI. Determining the efficacy and cost-effectiveness of the ActiValve: results of a long-term prospective trial. Laryngoscope 2011; 121: 769-76.