Have the following Blom-Singer items prepared for insertion of
the voice prosthesis:
• Blom-Singer indwelling voice prosthesis
• Blom-Singer Gel Caps
• Blom-Singer Dilator-Sizer or Blom-Singer Voice Prosthesis
Sizer, and Blom-Singer Puncture Dilator
• Blom-Singer voice prosthesis inserter
• Flange introducer
Dilate and Measure
Please refer to the Blom-Singer Dilation/Sizing System Instructions
For Use for complete product details.
Optional: The Blom-Singer Sizer or Puncture Dilator may be
used as an alternate procedure. Refer to the instructions for use
supplied with the product.
1. Dilate the TEP with a Blom-Singer Dilator-Sizer of the
appropriate diameter. Gently insert the Dilator-Sizer into the
puncture completely to the neck strap (diagram 2) and leave
in place for five minutes.
2. Carefully withdraw the Dilator-Sizer until very gentle resistance
is detected indicating that the esophageal wings are seated
against the anterior wall of the esophagus (diagram 2a).
Note: Pulling too firmly on the Dilator-Sizer may squeeze or
compress the TE tract resulting in an erroneous measurement
that indicates it is shorter than it actually is.
3. Note the marker that is closest to the entrance of the TE
puncture. Read the size number on the Dilator-Sizer and select
a Blom-Singer Indwelling Voice Prosthesis of corresponding
size. If the measurement is between two markers, select the
longer one.
4. Fully insert the Dilator-Sizer and fasten its neck strap with
medical adhesive tape on to the patient's peristomal skin.
Leave the Dilator-Sizer in the puncture to dilate 5 minutes,
or longer if necessary, in order to allow for easy insertion of
the selected indwelling voice prosthesis. Prior to insertion of
the Blom-Singer Indwelling Voice Prosthesis, remove the tape
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