Page 11 - Prosthetic voice rehabilitation-5th edition

2.4 ProvoxActiValve Provox ActiValve is a voice prosthesis specially developed for a sub-group of patients with a much shorter than average device life (see also Troubleshooting - frequent/early transprosthetic leakage).27 This short device life is not only caused by excessive and early biofilm formation, but also because of an under-pressure in the esophagus during breathing and swallowing, which opens the valve regularly. The biofilm problem is addressed through the use of Teflon-like material for valve and valve seat (on the left the normal ingrowth of biofilm in the silicone rubber; on the right the thinner biofilm laying on top of the inert fluoroplastic).28 The under-pressure issue is solved through the integration of magnets, which counteract this and cause an active closure of the valve (pictures below). This has resulted in a voice prosthesis, which shows a significantly longer device life than the regular Provox devices. On the next page a voice prosthesis is shown that for one-year has been in situ in a patient, who required a replacement of his Provox 2 voice prosthesis every 3 weeks. Leakage occurred because the hinge has become unstable, but valve and valve seat are still clean/intact. 11