Provoxweb
  • Provoxweb
  • Voice--Speech Rehab
    • Speech Therapy >
      • Introduction
      • Preoperative counseling
      • Outline of voice therapy
      • Important basic principles in voice rehabilitation in prosthetic speech
      • Some points of attention for the 'finishing touch'
      • General aspects of patient instruction
      • Problem solving
      • Conclusion
  • Pulmonary Rehab
    • Introduction
    • Heat and Moisture Exchangers (HME's) >
      • Treatment aspects
      • Prevention aspects
    • Provox HME >
      • Compliance aspects
      • Improvements in compliance
      • Improvements in voicing
      • Early post-operative pulmonary hygiene
      • Breathing resistance
      • Newest Provox HMEs
    • Treatment with inhalation medication
    • Conclusions
    • References

Anterograde replacement is difficult due to a small stoma

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Problem: due to a small stoma anterograde replacement is difficult

In experienced hands the replacement procedure is quick enough to allow a short blockage of the stoma without ‘choking’ the patient. Also, if the diameter of the stoma is so small that the loading tube is completely obstructing it, the patient probably should wear a trachea cannula, like the LaryTube or Lary Button, anyway. This should dilate the stoma well enough to allow replacement of the prosthesis. Otherwise a stoma plasty could be indicated. Another option is to use the traditional retrograde replacement method with the guide wire.


© The Netherlands Cancer Institute - 2003-18; ISBN 90-75575-05-X