Terminology

Primary placement

Placement of a voice prosthesis in a new esophagotrachel fistula created during laryngectomy (the prosthesis must be sterile)

Secondary placement

Placement of a voice prosthesis in a new esophagotracheal fistula once the total laryngectomy has healed completely

Changing the voice prosthesis

Insertion of a voice prosthesis in an existing esophagotracheal fistula to replace a faulty one

Shunt

Used in association with voice prostheses, the term is often used as an alternative for the esophagotracheal fistula

Esophagotracheal fistula

Artificial connection between the windpipe and the food pipe, at the same height as the tracheostoma

Anterograde insertion

The voice prostheses is inserted through the tracheostoma, i.e. from the front, into the esophagotracheal fistula

Retrograde insertion

The voice prosthesis is drawn through the mouth into the esophagotracheal fistula using a guide wire

Overshooting

Overshooting means just that - going beyond the target. In connection with voice prostheses, "overshooting" refers to the deliberate pushing of the complete voice prosthesis into the esophagus in anterograde insertion. Overshooting is used if the esopageal flange cannot be positioned safely in the esophagus using the standard insertion method, and is only possible with the insertion devices of the Progox® 2, Provox ActiValve® and Provox® Vega™ prostheses. After overshooting, the tracheal flange of the voice prosthesis has to be pulled back into the trachea using two vascular clamps. So the advantage of overshooting is the safe positioning of the esophageal flange in the esophagus. The disadvantage is the need to position the tracheal flange with clamps. Overshooting is not really desirable, and is only used in the management of complications (pocket formation in the shunt).

Reloading

Reloading means loading again. In connection with voice prostheses, the term refers to the reinsertion of the voice prosthesis in its insertion device.