Page 65 - Prosthetic voice rehabilitation-5th edition

Vega replacement VP reloading Vega overshooting The Provox Vega XtraSeal is inserted with the same Smart Inserter as the standard Vega prosthesis (see video below left). The only difference is that the thin extended esophageal flange, which is integrated underneath the standard esophageal flange, has to be folded downwards in order to achieve proper and comfortable loading of the voice prosthesis. This is especially important when the first attempt has failed and the voice prosthesis has to be reloaded. Deliberate downward folding of the thin extended esophageal flange is a must (see figure right). Moreover, it is advisable to always use the overshoot mechanism in order to ensure complete unfolding of the esophageal flanges in the lumen of the esophagus (see video below right). This unfolding the tracheal flange mostly has to be accomplished with the help of two hemostats. 23. 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. 65