Mayo-Yáñez M, et al. - This is the first study with a prospective case-crossover design comparing the device lifetime between the Provox Vega and Provox Vega XtraSeal and exploring possible related factors that affect their duration. The sample consisted of 20 laryngectomized individuals (mean age was 64.4 ± 6.66 years) with Provox Vega and periprothesis leakage to whom a Provox Vega XtraSeal was placed. In total, 230 prostheses were assessed. Findings revealed that the most common cause for replacement was due to an endoprosthesis leakage in both models. Data reported that mean life-time of Provox Vega was 104.474 ± 7.29 days and for the Provox XtraSeal was 176.76 ± 26.46 days. Complementary treatment with radiotherapy showed a higher device survival. Provox XtraSeal appears to be effectively decreasing the number of changes due to periprosthetic leakage, thereby increasing voice prosthesis survival.