Abstract
—We appreciate the opportunity to respond to Drs Blom and Singer. Their letter begins with the statement "As originators of three of the four prostheses that were the subject of Weinberg and Moon's recent article..." This statement is simply not true. For example, one of the four prostheses, the Voice Button, was developed by William Panje and is marketed by Xomed, Inc. A second prosthesis, the BIVONA Low Resistance device, was not designed by Blom or Singer. We have been evaluating tracheoesophageal puncture prostheses since their inception.<sup>1-6</sup>Our evaluations have consisted of both empirical testing and mathematical modeling. They have largely been directed toward specifying the opposition such devices offer to airflow through them. We personally shared the results of our earlier evaluations of duckbill devices with Blom.<sup>3</sup>In fact, our results led to our suggesting that Blom and Singer consider internalizing a valve and altering the
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