Attachment of the valve

In order to attach the automatic speaking valve in front of the stoma, two methods can be used: peristomal attachment and intratracheal fixation. Most clinicians prefer to try peristomal attachment as a first option, since intratracheal fixation might cause damage to the mucosa in the tracheostoma and when used in a wrong way it might dislocate the voice prosthesis. Below both methods of attachment are described.