Celebrating 35 Years of the Provox Voice Prosthesis

This year marks the 35th anniversary of the Provox voice prosthesis, a device that continues to give a voice to people who have undergone a total laryngectomy. To commemorate this milestone, we sat down with Frans Hilgers, one of the original developers of Provox, and Jan-Ove Persson, the co-founder of Atos Medical, to hear the story behind this innovative device. We are also excited to celebrate this anniversary alongside World Voice Day, a day dedicated to the importance of voice health and communication.

The inspiration behind Provox

Frans Hilger's journey began during his residency in ENT in 1974 when he encountered a patient who had undergone a total laryngectomy.

“This patient had an exceptionally good esophageal voice, unachievable by most patients, which sparked my interest in more reliable methods of voice rehabilitation,” says Frans. “This encounter, combined with my experience at the Netherlands Cancer Institute (NKI) and exposure to innovative surgical techniques, laid the foundation for what would become Provox.”

Early challenges and breakthrough

The development of Provox was not without its challenges. Early attempts to create a functional voice prosthesis faced issues such as leakage and poor retention. Frans recalls the pivotal moment when he attended a conference in San Francisco in 1980 and met Mark Singer, who had developed the Blom-Singer Prosthesis. This meeting inspired him to pursue a more effective solution, leading to a collaboration with Atos Medical.

In November 1987, Frans Hilgers and his colleague at the time sketched their ideas for a new voice prosthesis on a napkin during a meeting with the president of Atos Medical, Anders Williamson. This simple sketch marked the beginning of a fruitful collaboration. By May 1988, the first prototypes were ready, and by 1990, the Provox was officially on the market. The name "Provox" was chosen to combine pro (professional/positive/good) and vox (voice), a fitting tribute to the device's purpose.

Cooperation between Frans Hilgers and Atos Medical

It was through a Dutch company that Atos Medical connected with Frans. and his colleague in Amsterdam. They had the idea of creating a better voice prosthesis by combining the advantages and avoiding the disadvantages of different available models on the market. Jan-Ove then started investigating how to make such a prosthesis with the information received from the Dutch doctors.

Atos Medical soon realized that following their ideas would infringe on an American patent. By changing the design and incorporating a supporting ring made of fluoroplastic material, Atos Medical avoided the infringement risk and created a more stable and durable prosthesis. The 'blue ring' idea turned out to be a winner, increasing the device's life and improving the voice quality. Atos Medical then secured strong patent protection, preventing other companies from copying our solution.

According to Jan-Ove, Atos Medical’s cooperation with Frans was always productive. Jan-Ove tested different designs and provided feedback rapidly while Frans and his colleagues at the Netherlands Cancer Institute (NKI) conducted numerous clinical trials, often resulting in well-written and always peer-reviewed scientific articles. It was a true win-win situation.

“The most inspiring aspect of developing medical devices is meeting users who are satisfied with the products. I am proud that we continued to develop and finalize the Provox voice prostheses, even though some people thought the market was too small to be interesting for Atos,” says Jan-Ove.

Memorable moments

Jan-Ove recalls a memorable occasion when he met and heard the first patient speaking with the Provox voice prosthesis. Designing the prosthesis valve with light opening pressure while keeping it air and watertight and producible was a main challenge. In the short term, the problem with candida growth on the prosthesis, which decreases the device's life, was a challenge. Many tried to solve it, but all failed. Voice-producing elements were one option. A new enhanced voice prosthesis, ActiValve, with extended device life and a possible enhanced surgical solution was promising.

“I really enjoyed developing a better prosthesis, and the contact with the Dutch doctors was very fruitful and fun. It was meaningful to develop a better voice prosthesis, as many patients benefited from it. We met many patients who expressed their gratitude for helping them regain their voice and life,” says Jan-Ove.

Addressing user needs

Over the years, Provox voice prosthesis has undergone numerous improvements, including the development of an anterograde insertion tool, Provox 2, Provox ActiValve, Provox Vega with Provox SmartInserter, and Provox Vega XtraSeal, each addressing specific user needs and enhancing patient outcomes.

The role of clinical research

Clinical research has been integral to the success of Provox voice prosthesis. Frans Hilgers emphasizes the importance of clinician-driven studies in identifying and solving problems, ensuring that Atos Medical devices meet the needs of their users. This commitment to research and innovation has solidified Atos Medical's reputation as a leader in voice prosthesis technology.

The future of voice prosthesis technology

As we celebrate 35 years of Provox voice prosthesis, we also look to the future. Frans Hilgers envisions continued advancements in voice prosthesis technology, with a focus on creating devices that last longer and provide even greater benefits to patients.

“The goal is to ensure that individuals who undergo a total laryngectomy can lead fulfilling lives with the ability to communicate effectively,” says Frans.

Provox voice prosthesis stands as a testament to the power of innovation and collaboration. From its humble beginnings to its status as a trusted name in voice prosthesis technology, Provox voice prosthesis has made an impact on the lives of many.

Looking back on what he is most proud of about Provox, Frans Hilgers commented on the “longevity of our relationship” which started in November 1987 and continues to this day. As we celebrate this milestone alongside World Voice Day, we honor the dedication and ingenuity of those who made it possible and look forward to the future of voice prosthesis technology.

Listen to our users

To show the impact Atos Medical’s voice prostheses have on the lives of people living with a laryngectomy, watch this video: