Mechanical ileus caused by a Provox® voice prosthesis -: An "latrogenic" enteral complication in voice prosthesis rehabilitation of laryngectomees

Background: During the exchange of a defect Provox-I(R) voice prosthesis followed by an insertion of a Provox-II(R) voice prosthesis the esophageal part of the prosthesis often is pushed into the esophagus, as the enteral passage of the prosthesis was thought to be less traumatic for the voice shunt in comparison to a complete extraction of the stiff esophageal flange through the tracheostoma. This procedure is also recommended in the users video of the ATOS(R) company. Case: A laryngectomized patient, in whom the change of the voice prosthesis was carried out pushing the esophageal flange of the prosthesis into the esophagus, developed a mechanical ileus, as the voice prosthesis got stuck in Bauhin's valve. This resulted in the necessity of a laparatomy for removal of the voice prosthesis. Conclusion: During the replacement of the Provox(R) voice prosthesis it is necessary in all cases that the esophageal remnant of the voice prosthesis either is pulled out of the tracheoesophageal shunt via the tracheostoma or removed with a guide-wire transorally.