Fabrication of a custom silicone tracheostomal prosthesis.

Patients with a tracheostomy stoma experience compromised speech due to the associated changes in airflow patterns. Prosthetic obturation of the stoma restores the normal airflow patterns required for proper speech. Standard stent tubes may not adequately obturate the defect and may be uncomfortable to wear. The fabrication of a custom silicone tracheostomal prosthesis, incorporating a speaking valve, provides proper obturation of the defect and improved patient comfort, fit, and function. This article presents the procedures used to make a functional impression of a tracheostomy stoma and to fabricate a custom tracheostomal prosthesis.