Description

A low pressure voice prosthesis is a specialized medical device designed to restore speech for individuals who have undergone a total laryngectomy. This device is strategically placed in a surgically created tracheoesophageal puncture (TEP) between the trachea and esophagus. Its primary function is to enable speech by allowing air to pass from the lungs into the esophagus while preventing the aspiration of food and liquids.

Key Features

• One-Way Valve Mechanism: The prosthesis features a one-way flapper valve that effectively prevents aspiration, ensuring safety during use.
• Material: Constructed from medical grade silicone elastomer, providing durability and compatibility with the human body.
• Size Variability: Available in multiple sizes, including 16 French and 20 French diameters, with various lengths to accommodate different anatomical needs.
• Antibacterial Properties: Some models incorporate antibacterial additives or silver oxide to reduce Candida growth, enhancing hygiene.

Types and Models

The device is available in both indwelling and non-indwelling types:

• Indwelling Models: These are clinician-changed and may include models like the Blom-Singer Indwelling 2000, which features antibacterial properties.
• Non-Indwelling Models: These are patient-changeable, allowing for self-insertion, removal, and cleaning, offering greater independence.

Accessories and Maintenance

Optional accessories include inserter tools, gel caps, flushing devices, brushes, and plug inserts. These devices are provided either sterile or nonsterile and are intended for prescription use only. Proper maintenance and regular cleaning are crucial for the device's functionality and longevity.

Clinical Performance

The lifespan of these devices typically ranges from 2 to 10 months, with valve leakage being the most common reason for replacement. Indwelling prostheses generally require less maintenance and have a longer lifespan compared to non-indwelling types. However, there is no significant difference in voicing quality between the two types.

Patient Considerations

• Independence: Non-indwelling prostheses offer patients the ability to manage the device independently, which can be beneficial for those with the necessary dexterity and vision.
• Clinician Support: Indwelling prostheses are more suitable for patients who prefer or require clinician assistance due to limited dexterity or other factors.
• Hands-Free Options: Available for some users, enhancing convenience.

Suitability and Selection

Device selection should be based on individual anatomy, personal preferences, and professional medical advice. Proper cleaning and maintenance are essential to ensure the device functions effectively and lasts as long as possible. Contraindications include limited suitability for pediatric use, which should be assessed by a healthcare professional.