Patients can use prosthesis plugs to close the voice prosthesis if the valve starts to leak in order to prevent aspiration until the faulty prosthesis can be replaced by a new one. The plugs are mostly specific to certain prostheses. Because of the differing inner diameters of the voice prostheses, only the manufacturer's original plug in the right shaft diameter to match the prosthesis can be used and relied upon.
The plug seals the voice prosthesis completely, which means speech is not possible when the plug is in place. However, there are plugs on the market that contain a valve that does enable speech, albeit with slightly higher pressure (because of the smaller inner diameter).
The plug is inserted by the patient, ideally in front of a mirror. This requires a little practice. If the patient presses too hard against the prosthesis, it may fall into the esophagus. It is also important to attach the plug securely, either using a plaster strip or a collar, as the little plugs can easily fall into the trachea. As a general rule, a plug is an emergency solution for a few hours to a few days. Ideally, the faulty voice prosthesis should be replaced as promptly as possible.
Plugs are not available for all prostheses.
Plugs are available for:
- Provox®1, Provox® 2, Provox® Vega
- Blom-Singer® Classic Indwelling 20 Fr and 16 Fr prostheses (also with valves in the plugs for prostheses from a length of 6 mm)
- Tracoe® Voicemaster
- Heimomed® Phonax
With all of these plugs (Provox® Plug, Blom-Singer® Valved Plug and Blom-Singer® Plug) it is extremely important that they are pushed all the way into the prosthesis, i.e. until the plug flange is right up against the tracheal flange of the prosthesis. Only then will the plug hook safely into the prosthesis and seal properly. To achieve this, both designs have lips on the plug that make sure it hooks into the prosthesis. When pushing the plugs into the prosthesis, care must be taken not to exert excess pressure on the prosthesis as otherwise it could dislodge into the esophagus. Patients must be aware of this and given the appropriate instruction.