Changing your voice prosthesis

Key points

• Voice prostheses need to be replaced every 3-4 months on average.
• Most voice prostheses are inserted and replaced by your clinician.
• Leakage is the most common reason for getting a new prosthesis.
• If you notice any changes to the appearance of your prosthesis or the surrounding tissue, you should always check with your clinician

Introduction

Is your voice prosthesis working as well as it should be? Learn to recognise when it’s time for a new one.

Look out for changes

Voice prostheses are not permanent implants. How long yours lasts will depend on a number of factors. For example, these could include your diet, level of daily care, saliva content, or reflux. While some of these factors can be controlled, others cannot.

If you notice any changes to your prosthesis or the surrounding tissue, you may require a replacement or clinical check-up. By being alert and acting quickly if you notice something unusual, you can avoid problems later on.

Voice prosthesis - related issues

From the moment your voice prosthesis is inserted, it will be exposed to naturally occurring bacteria and yeast. This bacteria and yeast gradually breaks down the material of your voice prosthesis causing it to leak, look different or lose some of its functionality.

Leakage through your prosthesis

‘Leakage through’ is the most common indication that you need to change your voice prosthesis. This happens when a build up of bacteria and yeast stops the valve door of your prosthesis from closing properly. You may notice coughing after swallowing, as fluids pass through the open valve into your windpipe. Another sign of 'leakage through' is food stained mucus.

Change of colour or shape

The longer you have a voice prosthesis, the more likely it is to become discoloured or deformed. If you notice the appearance of your prosthesis starting to change significantly, then this is an equally valid reason to replace it.

Health of surrounding tissue

It's important to pay attention to the health of the tissue surrounding the voice prosthesis. If you notice any changes, including any of these listed below, contact your clinician immediately.

Leakage around your prosthesis

This could be a sign that the length of your voice prosthesis isn’t right. If it is too long, the voice prosthesis will be able to shift back and forth. You could get a similar sort of leakage if there is a poor seal around your prosthesis.

Dislodged voice prosthesis

If the tissue around your prosthesis is weak and not very flexible, the voice prosthesis may dislodge. This could happen after heavy coughing or a forceful cleaning of the prosthesis. If your voice prosthesis dislodges, follow the emergency procedures your clinician has given you and contact them straight away.

Tissue overgrowing the voice prosthesis

Although a rare occurance, you may experience 'granulation'. This refers to extra tissue that can form as a result of irritation. This tissue may grow over your voice prosthesis. If you notice this, contact your clinician to discuss what to do - a longer prosthesis may help until the granulation tissue resolves.

Have a question? Ask away!

You should never hesitate to approach your clinician - they are there for you. Particularly if you suspect your voice prosthesis is leaking, or you notice something that looks different.

You should also seek medical advice if:

• Your voice prosthesis is missing
• The position of your voice prosthesis has changed
• You have sore, red or irritated tissue around your voice prosthesis
• Cleaning your voice prosthesis has become painful, or you have seen blood on the brush
• The sound of your voice has changed, or voicing now requires more effort than usual