Page 7 - Supplement to 5th edition - New Provox Vega insertion system
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even leading to a slightly shorter device life, because patients became less reluctant to have the prosthesis changed (6). Besides the Provox methods, the gel cap procedure for the softer-flanged indwelling Blom-Singer voice prostheses was the method of choice for many clinicians using that system (4). This method is somewhat more time consuming than the Provox procedure, though, because it requires dissolving of the capsule. This takes a couple of minutes and sometimes requires drinking of water to speed up the dissolution of the gel cap.
Especially, in countries where Speech Language Pathologists were the main clinician group responsible for laryngectomee care, for the Provox voice prostheses there was a request to further ease the replacement method. This lead to the development of the Smart Inserter, which automated the loading procedure and decreased the chance of involuntary overshooting of the voice prosthesis (3, 7). Now, with the introduction of the Vega Insertion System all three methods are joined in one system, which makes the choice for clinicians and patients easier.
1. Hilgers FJ, Ackerstaff AH, Balm AJ, Tan IB, Aaronson NK, Persson JO. Development and clinical evaluation of a second-generation voice prosthesis (Provox 2), designed for anterograde and retrograde insertion. Acta Otolaryngol. 1997;117(6):889-96.
2. Hilgers FJM, Schouwenburg PF. A new low-resistance, self-retaining prosthesis (Provoxr) for voice rehabilitation after total laryngectomy. Laryngoscope. 1990;100:1202-7. 3. Hilgers FJ, Ackerstaff AH, van Rossum M, Jacobi I, Balm AJ, Tan IB, et al. Clinical phase I/feasibility study of the next generation indwelling Provox voice prosthesis (Provox Vega). Acta Otolaryngol. 2010;130(4):511-9.
4. Leder SB, Erskine MC. Voice restoration after laryngectomy: experience with the Blom-Singer extended-wear indwelling tracheoesophageal voice prosthesis. Head Neck. 1997;19(6):487-93.
5. Nijdam HF, Annyas AA, Schutte HK, Leever H. A new prosthesis for voice rehabilitation after laryngectomy. ArchOtorhinolaryngol. 1982;237:27-33.
6. Ackerstaff AH, Hilgers FJ, Meeuwis CA, van der Velden LA, van den Hoogen FJ, Marres HA, et al. Multi-institutional assessment of the Provox 2 voice prosthesis. Arch Otolaryngol Head Neck Surg. 1999;125(2):167-73.
7. Hilgers FJ, Ackerstaff AH, Jacobi I, Balm AJ, Tan IB, van den Brekel MW. Prospective clinical phase II study of two new indwelling voice prostheses (Provox Vega 22.5 and 20 Fr) and a novel anterograde insertion device (Provox Smart Inserter). Laryngoscope. 2010;120(6):1135-43.

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