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

Problems with intratracheal fixation

  • Tracheostoma enlarges after using some time

    • Never use a larger button or cannula. Allow the stoma to shrink overnight or during a couple of days, by wearing an adhesive and HME.

  • Bleeding of tracheostoma

    • Stop using the device. After the stoma is healed try to increase the length of use of the device gradually. When even short periods of using cause bleeding or when bleeding maintained for a long time after removing the device, stop using it.

    • Observe how patient is putting the device into the stoma and taking it out. Give proper instruction to avoid damage of tracheostoma or voice prosthesis

  • Air escaping between button and FreeHands HME.

    • When using the Barton-Mayo button, after some time the material of the button weakens and air starts to leak between the button and the FreeHands HME. In that case a metal ring can be used to support the button.

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