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Troubleshooting Procedures for Tracheoesophageal Punctures

What to do if the prosthesis comes out:

IMMEDIATELY put a red rubber catheter in the puncture tract and locate voice prosthesis if possible.

  1. If unable to get the catheter through the tract, DO NOT FORCE IT.  Go immediately to the emergency room to have the red rubber catheter placed.
  2. If able, preferably go the UPMC Presbyterian’s Emergency Department and ask them to have the Otolaryngologist/ENT assess you.
  3. If unable to locate voice prosthesis, go to the Emergency Room.  A Chest X-ray must be completed to determine if the voice prosthesis is in the lungs and requires removal.

The puncture must have a voice prosthesis or red rubber catheter in place to prevent closure and/or leaking.  Do not attempt to eat or drink without voice prosthesis or red rubber catheter in place.
Call to schedule an appointment with the Speech Pathologist for placement of new voice prosthesis (412-647-2100).

What to do if the prosthesis is leaking:

  1. If leaking is observed through the voice prosthesis, first attempt to thoroughly clean the prosthesis.  If leaking persists, attempt to thicken your liquids. (Thickener can be purchased at your local pharmacy)
  2. If leaking is observed around the voice prosthesis, attempt to thicken your liquids.
  3. If thickening of your liquids does not eliminate leaking, call and schedule an appointment with the Speech Pathologist (412-647-2100) as soon as possible.
    • Persistent leaking can lead to respiratory distress, increased mucous production, and aspiration pneumonia.
  4. If leaking is eliminated by thickening your liquids, call and schedule an appointment with the Speech Pathologist at your convenience (412-647-2100).

What to do if you lose your voice:

  1. If you notice any difficulties or changes in voicing, first attempt to thoroughly clean your voice prosthesis. 
  2. If cleaning does not improve your vocal quality, call and schedule an appointment with the Speech Pathologist (412-647-2100).

What to do if your stoma appears smaller:

  1. If your stoma appears to be getting smaller, place the laryngectomy tube that was provided in the hospital or by the Speech Pathologist.
    • Failure to place the laryngectomy tube may lead to respiratory distress.
  2. If you have lost your laryngectomy tube, please call and schedule an appointment with the Speech Pathologist (412-647-2100) to be fitted with a replacement laryngectomy tube.

Please call 412-647-2100 to call and schedule an appointment with the Speech Pathologist M-F or to leave a message for the Speech Pathology team.