Biofilm formation in vivo on perfluoro-alkylsiloxane-modified voice prostheses

Emmanuel P.J.M. Everaert, Hans F. Mahieu, Betsy van de Belt-Gritter, A. Jeanne G.E. Peeters, Gijsbertus J. Verkerke, Henny C. van der Mei, Henk J. Busscher*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

49 Citations (Scopus)


Objective: To study the influence of perfluoroalkylsiloxane (PA) surface modification of silicone rubber voice prostheses on biofouling.

Design: Placebo-controlled clinical trial. Setting: Tertiary referral center, with specialization in head and neck cancer treatment.

Patients: Eighteen consecutive patients with laryngectomies and experienced in the use of a voice prosthesis who visited the outpatient clinic for prosthesis replacement.

Material: Eighteen partially surface-modified voice prostheses (3 with short-chain PAs [1 fluorocarbonunit] and 15 with long-chain PAs [8 fluorocarbon units]) were inserted via the patients' tracheoesophageal shunts and remained in place for 2 to 8 weeks.

Intervention: Replacement of the prostheses.

Main Outcome Measures: Evaluation of biofilm formation on short- and long-chain PA-modified and original silicone rubber surfaces on the esophageal side of the voice prosthesis.

Results: The planimetrical biofilm scores of the surfaces of all 3 short-chain PA-treated voice prostheses indicated more biofouling on the treated surfaces than on the untreated surfaces of the same prostheses. For the longchain PA-treated prostheses, the planimetrical biofilm scores, as well as the numbers of colony-forming units per cm-2 for bacteria and yeasts indicated less biofouling on the treated side than on the control side for 9 the 13 prostheses that could be analyzed (2 were lost to analysis). Identical fungal strains, mainly Candida sp, were isolated from biofilms on each side of the esophageal flange.

Conclusions: Chemisorption of long-chain PAs by the silicone rubber used for voice prostheses reduces biofilm formation in vivo and therefore can be expected to prolong the life of these prostheses. Chemisorption of short-chain PAs by silicone rubber seems to have an adverse effect.

Original languageEnglish
Pages (from-to)1329-1332
Number of pages4
JournalArchives of Otolaryngology - Head and Neck Surgery
Issue number12
Publication statusPublished - Dec 1999
Externally publishedYes


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