Aspirated Voice Prosthesis: A Unique Complication of Post Total Laryngectomy Voice Rehabilitation

Background/objectives: Prosthetic voice rehabilitation after total laryngectomy has proven to be successful in restoring proper speech function in over 90% of patients. The possibility of achieving effective speech using the voice prosthesis is superior to esophageal speech and electrolarynx. Setting: Department of Head and Neck Oncosurgery, Kidwai Memorial Institute of Oncology, Bengaluru. Case report: A 75-year-old female who had undergone wide field laryngectomy 14 months back came with history of lost voice prosthesis which was later found aspirated. It was removed by the bronchoscopic forceps under topical anesthesia by visualizing it by a nasal 0° wide angle endoscope. The puncture site was cleaned and allowed to cicatrize and narrow down. The fistula was closed by topical application of silver nitrate. Conclusion: Tracheoesophageal puncture and prosthesis rehabilitation has emerged as the standard voice rehabilitation of laryngectomized patients. Patient education regarding maintenance of the prosthesis and the care for the tracheostoma is important in reducing the complications.