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Guidelines for preventing Candida buildup on voice prostheses

December 29 2017

Fitting an indwelling voice prosthesis (VP) allows patients to regain their speech following laryngectomy, but the material they are usually made of – silicone rubber – is prone to colonization by a biofilm of microorganisms, in particular by the yeast Candida albicans. As well as being a source of infection, this can lead to failure of the valve resulting in the need to replace the VP, or even aspiration pneumonia.

A set of guidelines for preventing this buildup has been developed by a multidisciplinary team (names and affiliations below) at East Kent Hospitals University NHS Foundation Trust and the University of Kent, which can extend the lifespan of prostheses from 2-3 weeks to more than 6 months, and they are currently being rolled out across the UK and also in Australia. Read the guidelines and management pathway in full, and press releases from the University of Kent and East Kent Hospitals University NHS Foundation Trust



  • Sarah Stevens/Leila Williams (Speech and Language Therapy)
  • Prof. Fritz Muhlschlegel (Clinical Director of Pathology)
  • Mr. Alistair Balfour (ENT Consultant)
  • Dr. Mark Baker (Microbiology services)
  • ​Carolyn McCall/Madhu Thazhath Veettil (ENT Specialist Nurse)
  • Julie Hawkes-Reekie/Moira Talpaert (Pharmacy)

University of Kent:

  • Dr. Campbell Gourlay (School of Biosciences)
  • Daniel Pentland (School of Biosciences)
  • Viktorija Makarovaite (School of Electronics and Digital Arts/ School of Biosciences)


Read a review article by the same authors on preventing biofilm formation: Talpaert et al. (2017) Candida biofilm formation on voice prostheses, Journal of Medical Microbiology (2015), 64, 199–208

Key points:

  • Modify VP surfaces with perfluoro-alkylsiloxane treatment or metals
  • Use prophylactic antifungals and synthetic salivary peptides
  • Advise patients to increase consumption of buttermilk and other probiotics

Image from Talpaert et al (2017), showing voice prosthesis before (a) and 3 months after (b) insertion in a laryngectomized patient.