Page 10 - Prosthetic voice rehabilitation-5th edition

2.3 ProvoxVegaandSmartInserter Recently a third generation Provox voice prosthesis, Provox Vega, with a novel insertion system, called Smart Inserter, has been developed.23,24 The main advantage of this completely redesigned voice prosthesis is that its airflow characteristics have been optimized through an increase of the internal diameter without altering the external diameter of 22.5 Fr, an angled position of the valve and a valve seat that keeps the valve free of the silicone part of the prosthesis. Moreover, the valve is less prone to come into direct contact with the esophageal mucosa, because of its internalization and a 360-degree hood at the esophageal side. This decreased airflow resistance makes voicing for many patients easier, as was observed in the various studies that have been carried out in recent years.23,25 Moreover, the insertion with the Smart Inserter makes replacement of the device in many instances considerably easier. Besides a 22.5 Fr version, the real successor of Provox 2, the Provox Vega prosthesis is also available in 20 and 17 Fr versions, also with optimized airflow characteristics.26 3. Hilgers FJ, Ackerstaff AH, Jacobi I, Balm AJ, Tan IB, van den Brekel MW. Prospective clinical phase II study of two new indwelling voice prostheses (Provox Vega 22.5 and 20 Fr) and a novel anterograde insertion device (Provox Smart Inserter). Laryngoscope 2010; 120:1135-1143. 24. Hilgers FJ, Ackerstaff AH, van Rossum Met al. Clinical phase I/feasibility study of the next generation indwelling Provox voice prosthesis (Provox Vega). Acta Otolaryngol 2010; 130:511-519. 25. Lorenz KJ, Maier H. [Voice rehabilitation after laryngectomy. Initial clinical experience with the Provox- Vega(R) voice prosthesis and the SmartInserter(R) system]. HNO 2010; 58:1174-1183. 26. Ward EC, Hancock K, Lawson N, van As-Brooks CJ. Perceptual characteristics of tracheoesophageal speech production using the new indwelling Provox Vega voice prosthesis: a randomized controlled crossover trial. Head Neck 2011; 33:13-19. 10