The missing tracheoesophageal puncture prosthesis: Evaluation and management

February 25, 2013
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Abstract

Placement of a tracheoesophageal puncture prosthesis in the post-laryngectomy patient has significantly improved voice rehabilitation in this population. Rarely, the prosthesis may become dislodged, necessitating medical evaluation. We present the case of a 61-year-old man who presented to our Emergency Department with a missing prosthesis. We describe the evaluation and management of this patient and review the relevant literature. We conclude with the following algorithm: When a patient presents with a missing prosthesis, evaluation of the tracheobronchial tree must be performed. Once the pulmonary system is cleared, the prosthesis can be presumed in the gastrointestinal tract and allowed to pass. A new prosthesis or catheter should be placed in the tract to prevent aspiration.

Introduction

The placement of a voice prosthesis in the post-laryngectomy patient has provided significant improvement in voice rehabilitation and broadened the available methods of speech to include tracheoesophageal, esophageal, and electrolaryngeal speech. The voice prosthesis was first introduced in 1980 by Singer and Blom and allowed for the creation of newer voice prostheses in more recent years.1

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