Choosing the membrane
Shortness of breath
Using the walk and talk position
Provox FreeHands HME automatic speaking valve
Using the walk and talk position
Important basic principles in voice rehabilitation in prosthetic speech
Indications
Reference
References
Indications
Reference
References
Alternative surgical technique of secondary puncture
Comments
Conclusions
Insertion of a Provox voice prosthesis during TEP leading to leakage around the device
Introduction
Original Provox Voice Prosthesis
Problem solving
Provox measure
Provox2 voice prosthesis
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
Choosing the right prosthesis length
Granulation tissue interfering with the prosthesis
Indications
Introduction
Local infection, prosthesis displaced
Original Provox Voice Prosthesis
Prosthesis extruding from the fistula tract
Prosthesis has disappeared and seems to be ingested
Provox dilator
Provox measure
Provox2 voice prosthesis
Replacement of other voice prostheses by Provox
Replacement of the Provox (1) voice prosthesis
Some bleeding during and after removal of the prosthesis
Surgical instruments
Surgical technique
Surgical technique of primary TE puncture and introduction of the Provox voice prosthesis
TE fistula deep down in trachea, making replacement troublesome
Surgical instruments
Surgical technique of primary TE puncture and introduction of the Provox voice prosthesis
General aspects of patient instruction
Granulation tissue interfering with the prosthesis
Insertion of a Provox voice prosthesis during TEP leading to leakage around the device
Interfering hypertrophic tissue in the TEP area
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
Outline of voice therapy
Prosthesis extruding from the fistula tract
Prosthesis has disappeared and seems to be aspirated
TE fistula migrated upwards outside the trachea, voicing problematic
There seems to be a 'separation of the party wall'
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
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
Indications
References
Reference
References
Chemical denervation of constrictor pharyngeus muscles with Botulinum toxin
General Introduction
Introduction
Original Provox Voice Prosthesis
Reference
References
Surgical technique
Total laryngectomy
Troubleshooting
Leakage through the prosthesis
Very frequent replacement due to leakage
Comments
Confusing hands-free TE-speech with esophageal speech
Fluency
Introduction
Leakage around the prosthesis even with the shortest length (4.5 mm)
Original Provox Voice Prosthesis
Problem solving
Prosody
Provox FreeHands HME
References
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
Attachment of the valve
Comments
Conclusions
Important basic principles in voice rehabilitation in prosthetic speech
Intratracheal fixation
Introduction
Outline of voice therapy
Problem solving
Problems with intratracheal fixation
Provox2 Voice Prosthesis
Reference
References
Replacement procedures
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 migrated upwards outside the trachea, voicing problematic
Total laryngectomy
Tracheostoma construction
Comments
Conclusions
References
Surgical technique
Total laryngectomy
Tracheostoma construction
Comments
Conclusions
Reference
References
Tracheostoma construction
Original Provox Voice Prosthesis
Provox2 voice prosthesis
Air escaping underneath cough-relief valve
Introduction
Candida overgrowth
Chemical denervation of constrictor pharyngeus muscles with Botulinum toxin
Granulation tissue interfering with the prosthesis
Indications
Interfering hypertrophic tissue in the TEP area
Introduction
Leakage around the prosthesis even with the shortest length (4.5 mm)
Local infection, prosthesis displaced
Local infection, prosthesis seems to be OK
Preoperative screening
Prosthesis extruding from the fistula tract
References
Treatment aspects
Treatment with inhalation medication in laryngectomized patients
Voice sounds strenuous and speaking requires too much effort
Alternative surgical technique of secondary puncture
Surgical instruments
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
Indications
Introduction
Troubleshooting