2021 Volume 67 Issue 1 Pages 31-36
Provox® is used as a substitute voice after laryngectomy, but we may sometimes need to remove this device. This time, we report that we had difficulty in closing a tracheoesophageal fistula after removing a Provox®. The patient was a 78-year-old man. After removing the Provox®, we could not close the tracheoesophageal fistula by repeated simple suturing. We finally succeeded in closing the fistula by interpositioning the previously transferred pectoral major muscle flap between the esophagus and the trachea. The closure of the fistula after Provox® removal may require a procedure to separate the trachea from the esophagus and then to interposition well vascularized tissue. This case suggests that there is a high possibility of encountering difficulty in closing such a fistula, especially in cases who have undergone radiation therapy. As a result the decision to select Provox® placement should be made very carefully and after such placement it should only be removed when it is absolutely necessary.
