Premium
Trachea stoma vent voice prosthesis
Author(s) -
Shapiro Myron J.,
Ramanathan Vadakkencherry R.
Publication year - 1982
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-198910000-00003
Subject(s) - silastic , prosthesis , stoma (medicine) , medicine , voice prosthesis , surgery , laryngotracheal stenosis , airway , anatomy , laryngectomy , larynx , tracheal stenosis
Abstract Having been in use for the past couple of years, the “duckbill” valved Silastic® tube developed by Blom and Singer is well established as a device for vocal rehabilitation of the laryngectomee. The newer “voice button” prosthesis developed by Panje incorporates a similar valve in Silastic®. Neither of these devices can be used with tracheal stomal stenosis or with a deep tracheal stoma behind prominent sternomastoid muscles. The ritual of taping the Blom‐Singer prosthesis and the frequent failure of the tape to hold are other distinct disadvantages. Limitations are imposed on patient selection with the Panje prosthesis because of the rigid dimensions and the possibility of aspiration of the device, as well as the necessity for manual dexterity on the part of the patient. A new device has been fashioned utilizing the “duckbill” Silastic® tube as a valve attached to a new type of trachea stoma button. This appears to have universal application, is not difficult to change, requires no taping, and is self‐maintaining. There is no possibility of aspiration. The device is simple and appears to overcome many of the disadvantages of the other two. The tracheal esophageal puncture must be made in a cephalad direction so that the tracheal air diverted through the prosthesis will be directed toward the pharynx and not toward the esophagus. Prostheses directed caudad will not function and those patients should be repunctured.