The Inhealth Blom-Singer Dilator-Sizer is a combination of a Puncture Dilator and a Voice Prosthesis Sizer. The Dilator-Sizer is used to dilate the puncture to ease voice prosthesis insertion; and as a Voice Prosthesis Sizer, it is used to measure the length of the tracheoesophageal puncture tract between the trachea and the esophagus to determine the appropriate voice prosthesis length.

Incremental millimeter markings and numbers on the device correspond to the lengths of Blom-Singer Voice Prostheses. This device is only available to use by a qualified, trained medical professional.

How to use the Blom-singer dilator sizer?

1. The Dilator-Sizer, of the appropriate diameter, is inserted gently by the Clinician completely into the TE puncture. Note: if the puncture angles are straight back or slightly downward, insert the dilator such that its curvature is also directed downward. If the puncture angles are in an upward plane, insert the dilator such that its curvature is also directed in an upward direction.

2. Remove the dilator if the patient experiences gagging or discomfort. 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.

3. 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. Note the marker that is closest to the entrance of the TE puncture.

4. Read the size number on the Dilator-Sizer and select a BlomSinger voice prosthesis of the corresponding size. If the measurement is between two markers, select the longer one. Fully insert the Dilator-Sizer and fasten the neck strap with adhesive tape onto the patient’s neck.

5. Leave the Dilator-Sizer in the puncture to dilate for 5 minutes, or longer if necessary, in order to allow for easy insertion of the selected voice prosthesis. Prior to insertion of the Blom-Singer voice prosthesis, remove the tape from the neck strap, grasp the dilator securely, and carefully withdraw it from the puncture. Immediately insert the voice prosthesis