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LOUIS A. MODICA, MD
Johnson City, Tenn

Arch Otolaryngol Head Neck Surg. 1987;113(4):436-437.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—Recent communications from the Netherlands have alerted us to the potential of Candida colonization to cause malfunction of Groningen button tracheoesophageal voice prostheses.^1,2 The use of oral antifungal agents, specifically amphotericin B, to control this problem is intriguing. Although oral antifungals rarely are associated with significant complication, would not removal and cleaning of the prosthesis be simpler, more economical, and safer than a course of antimicrobial therapy, requiring a dose several times daily?

Our patients who have undergone tracheoesophageal fistula voice restoration wash their prosthesis with soap and water once or twice a week. This keeps the prosthesis clean of food particles in addition to preventing gross fungal contamination. With this care, a Blom-Singer style prosthesis routinely functions for at least several months.

The Groningen device is promoted as not requiring regular removal and cleaning. If instead, routine use of antifungal agents is required, the value . . . [Full Text PDF of this Article]

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