A Randomized Trial Comparing Routine Use of the ActiValve to Standard Voice Prostheses

Primary Objective: To determine whether routine use of Provox® ActiValve® voice prosthesis decreases annual number of clinical procedures to exchange VP in indwelling voice prosthesis users after total laryngectomy with TEP. Secondary Objectives: 1. To compare outcomes, adverse events, and costs associated with routine use of Provox® ActiValve® (experimental) versus standard indwelling voice prostheses (comparator) 2. To compare outcomes, adverse events, and costs associated with prophylactic exchange of Provox® ActiValve® versus routine use of Provox® ActiValve® (experimental) or standard indwelling voice prostheses (comparator) Exploratory objectives: 1. To explore relationships between clinicodemographic features and device/TEP function 2. To explore relationships between pharyngoesophageal pressures via manometry and device/TEP function 3. To explore relationships between oral/tracheal microbiome and device/TEP function 4. To describe novel use of prophylactic exchange of Provox® ActiValve®