Elevated intra-tracheal pressure and effort for voicing

Problem: there is an elevated intra-tracheal pressure, c.q. effort needed for voicing

Reasons for this are hypertonicity of the neoglottis, a too long prosthesis (see previous page), esophageal mucosa overgrowth (pouch formation) needing a longer prosthesis or radiotherapy edema. See the different sections for the solution.