Leakage around or through the voice prosthesis

In time, the voice prosthesis may start to leak. Leakage frequently starts when fungi, yeasts and bacteria from the oral and throat cavity affect the voice prosthesis. These fungi and bacteria are present in the mouth and throat cavity in all people.

The prosthesis may also leak by wear and tear on the prosthesis itself.
When the voice prosthesis no longer functions adequately, this is particularly noticed during drinking. When drinking, fluid will leak through the prosthesis into the windpipe, inducing a cough reflex. The drink (e.g. coffee) can then be identified in the coughed up mucus.

Leaks may also occur around the voice prosthesis. The opening or fistula in which the prosthesis is positioned has then become too wide.

What to do in the event of a leak around or through the voice prosthesis?

1. First try cleaning the voice prosthesis.
2. After cleaning, try turning the voice prosthesis (to the right, 'clockwise', or left). Make sure the location where the safety strap was attached points downward.
3. Then check whether the leak has been stopped by drinking something.
4. Some cleaning may be achieved by forcefully blowing air through the voice prosthesis (flush).

5. If the leak cannot be fixed, contact the clinic.
6. The voice prosthesis will need to be changed after each leak, usually every 3-4 months. If there is a leak through the voice prosthesis, it can be closed (temporarily) during eating or drinking with a specifically designed prosthesis plug.

Until the prosthesis is replaced, it can be closed temporarily during eating or drinking with a specifically designed prosthesis plug ("stopper"). This prosthesis plug can be inserted into the voice prosthesis using the back of the brush. The voice prosthesis will then no longer leak. In that situation one can eat or drink, but not speak with the voice prosthesis.

The plug is removed after eating or drinking, to enable speech again. This plug will not help if the leak is around the prosthesis.


7. If the leak is around the voice prosthesis, the leak may be stopped using a Provost Flange. The silicon ring is designed to reduce leaks around the prosthesis in patients using the Provost voice prosthesis. The ring is inserted behind the tracheal flange. The ring is sterile. The ring is replaced during the voice prosthesis change, usually in the hospital.

Xtra flange