The Blom-Singer® Dilator-Sizer is a combination of puncture dilator and voice prosthesis sizer. Dilator-sizer is contraindicated in a tracheoesophageal puncture that has dilated substantially beyond the diameter of conventional 16Fr Blom-Singer® voice prosthesis. 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.