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

How much to downsize in case of shortening of the fistula tract

Picture
Problem: during retrograde insertion the guide wire gets stuck in the neoglottis

During the retrograde replacement of the Provox prosthesis, the guide-wire may become entrapped in the pharyngeal mucosal wall. By applying a smooth introduction movement and slight pressure, the guide wire will generally bend near the tip and still slide upward through the pharynx. "Swallowing" the guide wire and picking it up through the TE fistula with a forceps is another option.


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