Replacement of other voice prostheses by Provox
The Provox (1) and Provox2 voice prostheses can replace other voice prostheses, designed for use in a TE-fistula. In general, no problems are encountered with this replacement, as long as the length and the diameter of the TE-fistula are comparable with the dimensions of the Provox TE-fistula. The following rules for indwelling prostheses, such as Groningen and Blom-Singer devices, and non-indwelling prostheses, such as Blom-Singer or Bivona voice prostheses, can be of practical value:
Other indwelling voice prosthesis: if the TE-fistula is in the correct position no special measures have to be taken for replacement.
Non-indwelling voice prosthesis: because of the smaller diameter of these prostheses (16-20Fr), slight dilatation of the TE-fistula with the special Provox dilator after removal of the prosthesis may be needed. An example of a replacement of a Blom-Singer 16 Fr prosthesis for a Provox2 8mm prosthesis is shown in the pictures to the right. Due to the tapered end of the loading tube, no dilatation is needed in prostheses up to 8 mm of length. In the longer devices dilatation with the Provox dilator is strongly recommended. In these cases, the first introduction of the Provox or Provox2 device may sometimes be more easily accomplished under general anesthesia.