Larynx and airway: voice prosthesis leakage: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Larynx and airway: voice prosthesis leakage

Sample item

Months after a total laryngectomy with a tracheoesophageal voice prosthesis, a patient coughs whenever he drinks, and fluid is seen leaking through the lumen of the prosthesis. What is the commonest cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Candida colonisation of the silicone valve

Fungal colonisation of the silicone valve, mainly Candida, stops the flap closing and causes leakage through the prosthesis. Treatment is replacing the prosthesis, cleaning, and sometimes antifungal therapy. Leakage around the prosthesis suggests an enlarged tract or wrong length.

Option by option

  • A. Recurrent laryngeal tumour at the stoma

    Tumour recurrence does not make the valve incompetent.

  • B. Radiation fibrosis of the pharynx

    Radiation fibrosis affects the tissues around the device and not the valve.

  • C. Prosthesis that is too short

    A short prosthesis tends to cause leakage around, not through, the device.

  • D. Candida colonisation of the silicone valve (correct)

    Correct. Candida growth on the valve prevents closure and causes leakage through the device.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Candida colonisation of the silicone valve. Fungal colonisation of the silicone valve, mainly Candida, stops the flap closing and causes leakage through the prosthesis.

Why is "Recurrent laryngeal tumour at the stoma" not the answer?

Tumour recurrence does not make the valve incompetent.

Why is "Radiation fibrosis of the pharynx" not the answer?

Radiation fibrosis affects the tissues around the device and not the valve.

Why is "Prosthesis that is too short" not the answer?

A short prosthesis tends to cause leakage around, not through, the device.

What concept does this question test?

It tests Larynx and airway: voice prosthesis leakage in ENT. Treatment is replacing the prosthesis, cleaning, and sometimes antifungal therapy. Leakage around the prosthesis suggests an enlarged tract or wrong length.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Larynx and airway: voice prosthesis leakage?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.