Description

A voice prosthesis is an essential medical device designed to restore speech in individuals who have undergone a total laryngectomy. This particular model features a large esophageal flange, enhancing its functionality by providing a secure seal against the esophageal wall. Such a design is crucial in preventing leakage around the prosthesis, especially in cases where the tissue does not adequately grip the device or when tract dilation occurs.

Key Features

• One-Way Valve System: The prosthesis includes a one-way valve that allows air from the lungs to pass into the esophagus, facilitating speech by causing vibrations in the pharynx. Simultaneously, it prevents food, liquids, and saliva from entering the trachea, ensuring safety and functionality.

• Material Composition: Constructed from medical-grade silicone, often with anti-fungal additives like silver oxide, the device is designed to minimize biofilm and yeast growth, enhancing durability and hygiene.

• Indwelling and Non-Indwelling Options: The prosthesis is available in both indwelling and non-indwelling types. Indwelling models are typically changed by healthcare professionals, offering a longer lifespan and robust design. Non-indwelling models can be changed by the patient, providing greater independence but requiring good dexterity and eyesight.

Sizing and Insertion

Available in various sizes, commonly in diameters like 16FR and 20FR, and lengths ranging from 4mm to 14mm. Proper sizing is vital to accommodate individual anatomical needs and to ensure optimal voice quality. Insertion can be performed using specialized tools and may require a water-soluble lubricant for ease of placement.

Maintenance and Care

Regular cleaning is crucial to prevent biofilm and candida growth, which can lead to leakage and device malfunction. Maintenance typically involves brushing and flushing the inner lumen with warm water, especially after meals. Accessories such as cleaning brushes and flushing devices are available to aid in this process.

Precautions

Suitability for using this device is assessed through a sufflation test to ensure the patient can produce tracheoesophageal voice. Contraindications may include poor manual dexterity, impaired eyesight, inadequate pulmonary function, or specific anatomical factors. In case of dislodgement, timely replacement is necessary to maintain the puncture.

Common Challenges

Leakage due to biofilm formation, improper fit, or device wear is a common issue, often addressed by thorough cleaning, resizing, or replacing the prosthesis. Temporary plugs can manage leakage during eating or drinking but will inhibit speech while in use.

Conclusion

The VOICE PROSTHESIS LARGE ESOPHAGEAL FLANGE is a specialized device offering significant benefits for voice restoration post-laryngectomy. Its design and features cater to diverse patient needs, emphasizing proper maintenance and sizing for effective performance and patient satisfaction.