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Figure A.6: The Provox2 loading tube with prosthesis inside is inserted into the TEF. The prosthesis is then pushed forward by pushing the inserter while keeping the loading tube in position. The prosthesis will advance approximately 1 cm while a small part of the esophageal flange protrudes through the slit of the loading tube. This protruding part is then pressed inwards with the thumb to allow further advancement of the prosthesis and inserter in the loading tube to the mark line 1 on the inserter. The loading tube is placed into the tracheoesophageal fistula (TEF) reaching the posterior wall of the esophagus (figure A.6). While keeping the loading tube in position the prosthesis is pushed forward with the inserter to the mark line 2. At this point the esophageal flange is expanded. Now, the loading tube is pulled back while the voice prosthesis and inserter stay in place. By pulling the loading tube back the tracheal flange should expand thereby leaving the Provox2 voice prosthesis in its indwelling position. After having removed the loading tube over the inserter the proper fixation is checked. |
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