Cost-effectiveness Analysis of Vocal Rehabilitation With Strengthened Tracheoesophageal Voice Implant Prosthesis Versus Standard Voice Prosthesis in Case of Repeated Intra-prosthetic Leakage After Total Laryngectomy

Inclusion Criteria: * Patient treated surgically by total laryngectomy or total pharyngolaryngectomy or total circular pharyngolaryngectomy and carrying a voice prosthesis for at least 12 months * Patient carrying a standard voice prosthesis and having undergone 2 successive prosthesis replacements within 3 months of interval and/or requiring at least 4 changes in the last 12 months, for intraprosthetic leakage * Patients carrying a voice prosthesis, irrespective of the mark/model, of diameters between 16 and 20 French, and of length between 6 and 14 mm. * Prosthetic replacement available under local or general anaesthesia * Patient with primary cancer remission status * Patient agreeing to participate in the study and having given oral, express and informed consent Exclusion Criteria: * Patient with local, regional or metastatic tumor evolution * Patient who has had a first voice prosthesis for less than 12 months. * Patient with peri-prosthetic leakage * Patient presenting a dysfunction of the voice prosthesis not linked to an intra-prosthetic leak * Patients whose tracheal fistula is no longer opened, or justifying a new tracheoesophageal puncture * Patients with a voice prosthesis of a diameter strictly greater than 20 French * Patients with voice prosthesis of strictly less than 6 mm or greater than 14 mm length * Patient under anti-fungal treatment during the month prior to inclusion * Adult protected patients * Inability to complete the questionnaires * Patients wit…