Management techniques in the use of the Blom?Singer Valve

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Abstract
The use of a valve to restore functional speech following a total laryngectomy was described. Problems were encountered in both the formation of the tracheo-esophageal fistula and stenosis of the tracheostome if the valve is used by itself for long periods. A simple technique to establish the fistula is described, and a modification of the valve with a stoma button is suggested.

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