Prosthesis has disappeared and seems to be ingested
Problem: the voice prosthesis has disappeared and seems to be ingested
Accidental ingestion of the Provox or Provox2 voice prosthesis or other components of the Provox voice rehabilitation system may occur. Possible causes could be a local infection of the TE-fistula or the constant pressure of a trachea cannula, causing gradual overgrowth of tracheal mucosa. The animation on the left shows a possible course of events. In case of disappearance of the prosthesis, verify whether the device is indeed ingested and is not just hidden in the fistula under the mucosa. As with any other foreign body, the symptoms caused by ingestion depend largely on the size, location, degree of obstruction (if any), and the length of time it has been present. The ingested component in the lower esophagus may be removed by esophagoscopy or observed for a short period of time. The object may pass spontaneously into the stomach; in that case most foreign bodies usually pass the intestinal tract. Surgical removal of foreign bodies in the intestinal tract must be considered if bowel obstruction occurs, bleeding is present, perforation occurs, or if the object fails to pass through the intestinal tract. In case a reinsertion of the voice prosthesis is considered, proper measures should be taken to avoid reoccurrence of the ingestion (see leakage around the voice prosthesis).
Accidental ingestion of the Provox or Provox2 voice prosthesis or other components of the Provox voice rehabilitation system may occur. Possible causes could be a local infection of the TE-fistula or the constant pressure of a trachea cannula, causing gradual overgrowth of tracheal mucosa. The animation on the left shows a possible course of events. In case of disappearance of the prosthesis, verify whether the device is indeed ingested and is not just hidden in the fistula under the mucosa. As with any other foreign body, the symptoms caused by ingestion depend largely on the size, location, degree of obstruction (if any), and the length of time it has been present. The ingested component in the lower esophagus may be removed by esophagoscopy or observed for a short period of time. The object may pass spontaneously into the stomach; in that case most foreign bodies usually pass the intestinal tract. Surgical removal of foreign bodies in the intestinal tract must be considered if bowel obstruction occurs, bleeding is present, perforation occurs, or if the object fails to pass through the intestinal tract. In case a reinsertion of the voice prosthesis is considered, proper measures should be taken to avoid reoccurrence of the ingestion (see leakage around the voice prosthesis).
