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

TE fistula too wide to hold a voice prosthesis, surgery not an option

Problem: the TE fistula is too wide to hold a voice prosthesis and surgery is not an option anymore

A rare example of such a situation is shown in the top figure. The patient was in an end stage of a second primary cancer (non-small lung carcinoma) and severely cachectic. The solution was blocking the TE fistula with a nasal septal button, which was cut into shape (top left figure). In the next figure the situation after anterograde insertion of the nasal septal button is shown. In this way the intractable aspiration was stopped and the patient could tolerate liquids again.

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