Guidance for reinsertion of TEP voice prostheses

Proposed guidance for reinsertion of trachea-oesophageal puncture (TEP) voice prostheses

during the COVID-19 pandemic

Issued : 25 March 2020

To: UK head and neck multidisciplinary teams

BAHNO recognises that the management of many patients with cancer will have to be modified during the current COVID-19 crisis. One particular group that may cause management dilemmas are those with voice prostheses.

Reinsertion of tracheooesophageal puncture (TEP) voice prostheses

Attendance at hospital out-patient and Emergency Departments should be avoided

Contact patients by telephone/video call/email now with advice on altered service

Functioning voice prostheses should not be replaced however old

Central leakage should be managed by thickened fluids or plug first

If TEP fistula closing a new prosthesis should not be inserted

Prostheses may be reinserted to prevent aspiration but not for voice

If prosthesis requires changing consider a dummy valve which will avoid the risk of further central leakage until safe services are resumed.

Cyrus Kerawala

President BAHNO