inhealth Blom-Singer Instructions For Use Manual page 8

7. Insert a voice prosthesis of a length corresponding to the
associated sheath color band observed in step 5 into the
lumen of the transparent proximal end of the catheter
such that its esophageal retention flange is forward folded.
(Diagram 3) Insert the strap of the voice prosthesis through
the small window and out the proximal end of the catheter.
Gently pull on the strap while simultaneously deforming
the flanges with your fingers until the voice prosthesis is
positioned inside the catheter as shown in (Diagram 4).
8. Optionally, position the inserter stick (included with voice
prosthesis) into the voice prosthesis tracheal end, and attach
the strap to the inserter stick peg. (Diagram 5)
9. Insert the distal (narrow) catheter tip through the sheath,
past the pharynx protector and out the patient's pharyngeal
defect, mating up with and carrying the sheath along with it.
10. Firmly grasp the distal (narrow) end of the catheter and with
continuous force pull the catheter through the puncture.
Simultaneously guide and push the voice prosthesis with
the voice prosthesis inserter stick into the puncture until the
tracheal flange and strap rest exactly against the posterior
wall of the trachea. The voice prosthesis will separate from
the catheter. The folded esophageal retention flange will
deploy securely against the anterior wall of the esophagus.
(Diagram 6.1 if no inserter stick is used; or Diagram 6.2
if inserter stick is used) Directly observe that this has
occurred.
11. Remove and discard the pharynx protector.
12. Detach, remove and discard the inserter stick if used.
13. Once the esophageal retention flange has been confirmed
to have deployed, carefully detach the strap on the voice
prosthesis with scissors or suture into the midline peristomal
skin.
14. Closely monitor the voice prosthesis post-operatively and
carefully clean as needed in situ per instructions found with
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