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Tracheoesophageal voice prosthesis

Case contributed by Yahya Baba
Diagnosis certain

Presentation

History of an adenoid cystic carcinoma of the larynx treated with total laryngectomy. She had a transesophageal voice prosthesis 5 years ago. Presents for dysphagia. CT to rule out tumor recurrence.

Patient Data

Age: 35 years
Gender: Female
  • total laryngectomy with a transesophageal voice prosthesis is noted in situ

  • dilated and air-filled esophagus with a moderate amount of gas within the stomach and small bowel

  • there is no mass or nodular thickening suggestive of local recurrence in the surgical site

  • there is no lymphadenopathy

  • no esophageal stricture

  • no hiatus hernia

  • there is an enhancing left-sided frontotemporal extra-axial mass, in keeping with a meningioma

Case Discussion

There is no local recurrence or esophageal stricture explaining the dysphagia. However, swallowing difficulties may be caused by the esophageal flange of the voice prosthesis that may interrupt bolus flow. It can also contribute to residue accumulation on the prosthesis resulting in dysphagia 1.

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