title: Front-loading of Groningen voice prosthesis in alaryngeal patients requiring prosthetic replacement.
abstract: The Groningen voice prosthesis can be successfully replaced using the back-loading system. We have attempted to minimize patient stress by developing a front-loading system that does not require insertion of the introducer via the tracheo-oesophageal shunt to the oral cavity or the mesopharyngeal anaesthetization regularly used with the back-loading system. Using our front-loading system, the existing prosthesis is removed, then the posterior portion of the replacement Groningen prosthesis is grasped by a pair of nasal forceps with a small jaw to make an acute angle and inserted into the oesophageal cavity through the shunt at a stroke. All 20 patients who underwent forward-loading replacement of a Groningen (n = 17) or Blom-Singer (n = 3) valve with a Groningen valve tolerated the procedure well and experienced no complications except, in some cases, for minor bleeding just after insertion of the prosthesis. The procedure was completed within 30 seconds.
authors.affiliation: Department of Otorhinolaryngology, Kansai Medical University, Osaka, Japan. iwai@takii.kmu.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Iwai
authors.forename: M
authors.initials: M
authors.lastname: Adachi
authors.forename: T
authors.initials: T
authors.lastname: Yamashita
mesh_terms: D006801:Humans; D007831:Larynx, Artificial; D019919:Prosthesis Implantation / Q000379:methods*