Assembling and disassembling the HME
Attachment of the valve
Intratracheal fixation
Patient maintenance
Problems with intratracheal fixation
Surgical constrictor pharyngeus myotomy
Use of the cleaning container
Voicing is blocked by finger pressure on the stoma/voice prosthesis
Hypotonicity of the neoglottis
Seal of the adhesive does not last long
Weak/whispery/aphonic voice
How much to downsize in case of shortening of the fistula tract
Leakage around the prosthesis and the prosthesis is too long
How much to downsize in case of shortening of the fistula tract
Indications
Introduction
Prosthesis extruding from the fistula tract
Voicing increasingly difficult, not improved after replacement
How much to downsize in case of shortening of the fistula tract
Indications
Prosthesis extruding from the fistula tract
Chemical denervation of constrictor pharyngeus muscles with Botulinum toxin
Choosing the right prosthesis length
General Introduction
Important basic principles in voice rehabilitation in prosthetic speech
Indications
Introduction
Leakage around the prosthesis even with the shortest length (4.5 mm)
Provox dilator
References
General aspects of patient instruction
General Introduction
Pharyngeal reconstruction and prosthetic voice rehabilitation
Reference
References
Additional remarks in conjunction with prosthesis replacement
General Introduction
Important basic principles in voice rehabilitation in prosthetic speech
Intratracheal fixation
Introduction
Peristomal attachment
Primary tonicity control of the PE-segment
Provox dilator
Provox2 voice prosthesis
Replacement of other voice prostheses by Provox
Replacement of the Provox (1) voice prosthesis
Surgical technique
TE fistula too wide to hold a voice prosthesis, surgery not an option
Using the walk and talk position
Voice sounds strenuous and speaking requires too much effort
Candida overgrowth
Indications
Leakage through the prosthesis
Problem solving
Very frequent replacement due to leakage
Candida overgrowth
Problem solving
Candida overgrowth
Problem solving
Intratracheal fixation
Problems with intratracheal fixation
Prosody
Conclusion
Problem solving
Alternative surgical technique of secondary puncture
Surgical technique of secondary TE puncture and introduction of the Provox voice prosthesis
Indications
Total laryngectomy
Indications
Total laryngectomy
Reference
References
Comments
Tracheostoma construction
Intratracheal fixation
Problem solving
Provox LaryTube
Problem solving
Provox LaryTube
Indications
Introduction
Provox FreeHands HME
Provox FreeHands HME automatic speaking valve
Replacement of the Provox (1) voice prosthesis
Fluency
Introduction
Some points of attention for the ‘finishing touch’
Proper adjustment of the cough-relief valve
Too much noise of cough-relief valve when coughing
Additional remarks in conjunction with prosthesis replacement
Air escaping underneath cough-relief valve
Air leakage under membrane
Alternative surgical technique of secondary puncture
Anterograde insertion is difficult due to local infection
Anterograde replacement is difficult due to a small stoma
Assembling and disassembling the HME
Attachment of the valve
Breath-support/breath-voice coordination
Candida overgrowth
Chemical denervation of constrictor pharyngeus muscles with Botulinum toxin
Choosing the membrane
Choosing the right prosthesis length
Closure of the membrane
Comments
Conclusion
Conclusions
Confusing hands-free TE-speech with esophageal speech
Copyright information
Cough-relief valve opens when patient is speaking loud
Decrease backpressure
Deep stoma interfering with application of peristomal devices
During retrograde insertion the guide wire gets stuck in the neoglottis
Elevated intra-tracheal pressure and effort for voicing
Fluency
General aspects of patient instruction
General Introduction
Granulation tissue interfering with the prosthesis
How much to downsize in case of shortening of the fistula tract
Hypertonicity/spasm of the neoglottis
Hypotonicity of the neoglottis
Important basic principles in voice rehabilitation in prosthetic speech
Indications
Insertion of a Provox voice prosthesis during TEP leading to leakage around the device
Intelligibility
Interfering hypertrophic tissue in the TEP area
Intratracheal fixation
Introduction
Is it possible to remove the prosthesis by pushing the device into the esophagus
Leakage around the prosthesis and the prosthesis is too long
Leakage around the prosthesis even with the shortest length (4.5 mm)
Leakage through the prosthesis
Local infection, prosthesis displaced
Local infection, prosthesis seems to be OK
No voice sound
Original Provox Voice Prosthesis
Outline of voice therapy
Patient maintenance
Peristomal attachment
Pharyngeal reconstruction and prosthetic voice rehabilitation
Phrase length, speech rate, maximum phonation time
Pitch, loudness, intonation
Preoperative counseling
Preoperative screening
Primary tonicity control of the PE-segment
Problem solving
Problems with intratracheal fixation
Proper adjustment of the cough-relief valve
Prosody
Prosthesis extruding from the fistula tract
Prosthesis has disappeared and seems to be aspirated
Prosthesis has disappeared and seems to be ingested
Provox dilator
Provox FreeHands HME
Provox FreeHands HME automatic speaking valve
Provox HME
Provox LaryTube
Provox measure
Provox2 Voice Prosthesis
Reference
References
Replacement of other voice prostheses by Provox
Replacement of the Provox (1) voice prosthesis
Replacement procedures
Seal of the adhesive does not last long
Shortness of breath
Shouting
Some bleeding during and after removal of the prosthesis
Some points of attention for the ‘finishing touch’
Speech rate
Speech therapy. What to practice to optimize hands-free speech
Stenosis of the neopharynx
Surgical constrictor pharyngeus myotomy
Surgical instruments
Surgical technique
Surgical technique of primary TE puncture and introduction of the Provox voice prosthesis
Surgical technique of secondary TE puncture and introduction of the Provox voice prosthesis
Surgical techniques of tracheostoma reconstruction
TE fistula deep down in trachea, making replacement troublesome
TE fistula migrated upwards outside the trachea, voicing problematic
TE fistula too wide to hold a voice prosthesis, surgery not an option
There seems to be a 'separation of the party wall'
Too much noise of cough-relief valve when coughing
Total laryngectomy
Tracheostoma construction
Troubleshooting
Use of the cleaning container
Using the walk and talk position
Very frequent replacement due to leakage
Voice sounds strenuous and speaking requires too much effort
Voicing increasingly difficult, not improved after replacement
Voicing is blocked by finger pressure on the stoma/voice prosthesis
Voicing problems
Weak/whispery/aphonic voice
Choosing the membrane
Intratracheal fixation
Peristomal attachment
Problems with intratracheal fixation
Voicing is blocked by finger pressure on the stoma/voice prosthesis
Problems with intratracheal fixation
Voicing is blocked by finger pressure on the stoma/voice prosthesis
Choosing the right prosthesis length
General Introduction
Interfering hypertrophic tissue in the TEP area
Local infection, prosthesis seems to be OK
Problem solving
References
TE fistula deep down in trachea, making replacement troublesome
How much to downsize in case of shortening of the fistula tract
Indications
Introduction
Outline of voice therapy
Problem solving
Provox FreeHands HME automatic speaking valve
Provox2 Voice Prosthesis
Surgical techniques of tracheostoma reconstruction
There seems to be a 'separation of the party wall'
Total laryngectomy
Voicing increasingly difficult, not improved after replacement