VoiceMaster 3 



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Figure A.10: Schematic drawing of the VoiceMaster voice prosthesis after insertion with the safety strap removed. Occlusion of the stoma will shunt air from the lungs towards the esophagus and sound will be generaled.

However, when inserting the VoiceMaster voice prosthesis for the first time in a patient it is helpful to first use the 22 Fr Blom-Singer fistula stent. Using this stent allows the clinician to get informed about the direction of the fistula and slightly dilate the fistula to allow easier insertion.

Next, reverse the plunger until the yellow color is visible. At this point the prosthesis is locked onto the inserter but the esophageal flange is not stretched. Gentle pulling of the inserter allows the clinician to verify the right placement and fixation of the prosthesis. Once the clinician is sure of proper fixation the plunger can be reversed further until the red color is visible (prosthesis is not locked to the inserter) and the inserter can be detached from the prosthesis. The safety strap is also detached and can be clued to the peristomal skin with silicone skin adhesive or cut off. The insertion is complete and the patient can use the prosthesis (figure A.10).

Gluing the safety strap to the skin does give additional safety but at the same time it can hinder the use of Heat and Moisture Exchangers (HMEs) and tracheostoma valves. Since these devices are also glued to the same skin, removal of these devices increases the risk of accidental pulling of the voice prosthesis safety strap. This pulling increases the chance of dislodgment. For this reason we routinely remove the safety strap after insertion.

The removal of the VoiceMaster voice prosthesis is either done by reversing these steps or by pulling the device out with a hemostat.

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Copyright 1998 Medical Illustrations
Last modified: January 07, 1999

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