Blom-Singer® Large Esophageal Flange
Clinical application
The esophageal flange of the Blom-Singer® Large Esophageal Flange prosthesis has been increased to 19 mm (standard prosthesis approx. 12 mm). In the event of leakage around the voice prosthesis, the Large Esophageal Flange prosthesis can be introduced to seal it. The depth of the esophageal fistula is measured precisely, and a well-fitting Large Esophageal Flange prosthesis used instead of a standard prosthesis. The larger esophageal flange fits snugly against the esophageal mucous membrane, and seals the esophagus against the esophagotracheal fistula. In cases of extremely unstable, e.g. infected/necrotic esophagotracheal fistulas, the size of the tracheal flange may also be increased (custom fit; see Managing complications). The valve of the Blom-Singer® Large Esophageal Flange prosthesis is a low-resistance valve, non-biofilm resistant, and susceptible to shear stress and material fatigue. Since 2010, factory-modified prostheses with larger flanges, esophageal, on the tracheal side, on both sides, with a stronger valve and in special shafts lengths in 16 Fr and 20 Fr have been available to order through the Rapid Response Program.
Type of prosthesis: | Special prosthesis |
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Outer diameter of shaft: | 20 Fr or 16 Fr (6.6 mm or 5.9 mm) |
Shaft lengths: | 4-22 mm in 2 mm increments |
Material: | medical-grade silicone |
Valve type: | flap valve |
Method of insertion: | anterograde with a conical gel capsule |
Indication: | periprosthetic leakage |
Biofilm resistance: | no |
Underpressure stability: | available on request |
Non-fatiguing valve mechanism: | no |
Prevalence: | USA, Europe |
Literature
1. Kress P, Schäfer P, Schwerdtfeger FP., The custom-fit voice prosthesis, for treatment of periprothetic leakage after tracheoesophageal voice restoration, Laryngorhinootologie. 2006 Jul;85(7):496-500.
2. Blom E.D., Singer M.I., Hamaker R.C., Tracheoesophageal Voice Restoration Following Total Laryngectomy, Singular Publishing Group, San Diego, London, (1998)
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