Evaluation of voice prosthesis placement at the time of primary tracheoesophageal puncture with total laryngectomy

Deschler, Daniel G.; Bunting, Glenn; Lin, Derrick T.; Emerick, Kevin S.; Rocco, James W.

doi:10.1002/lary.20490

Cited by 34 publications

(51 citation statements)

References 19 publications

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“…Although other studies present higher speech rehabilitation success rates for TEP1 [26], this finding can be explained by the lower number of patients who underwent TEP2 and it is also possible that the immediate rehabilitation in TEP1 exerts a positive psychological impact, as suggested by Boscolo-Rizzo et al [20], motivating patients to intensify the search for oral communication. By contrast, the prolonged absence of the larynx in TEP2 leads to alteration of the esophageal muscles of these patients, who do not need airway protection anymore.…”

Section: Discussionmentioning

confidence: 40%

Comparison between Primary and Secondary Tracheoesophageal Puncture Prosthesis: A Systematic Review

Neto¹,

Dedivitis

Aires

et al. 2017

ORL

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Introduction: Since the introduction of tracheoesophageal puncture (TEP) and placement of voice prosthesis, this has become the method of choice to achieve speech rehabilitation after total laryngectomy. Objective: To compare the complications and success in speech rehabilitation of patients undergoing rehabilitation after primary and secondary TEP (TEP1 and TEP2) through a systematic review. Methods: The literature survey included research in MedLine, Scielo, Lilacs, Cochrane and Websco until June 2016. Results: The rate of leakage around the prosthesis was higher in TEP1 (22.5 vs. 6.9%, p = 0.03). There were higher rates of wound infection (9.1 vs. 3.9%) and tracheal stenosis (8.5 vs. 4.5%) in the TEP1 group compared to TEP2, however with no statistical significance. The evaluation of speech quality was not possible due to the heterogeneity of the studies. Conclusion: There is a reduction in the risk of leakage around the prosthesis among TEP2 patients.

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Section: Discussionmentioning

confidence: 40%

Comparison between Primary and Secondary Tracheoesophageal Puncture Prosthesis: A Systematic Review

Neto¹,

Dedivitis

Aires

et al. 2017

ORL

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“…This is consistent with our historical experience. 4,8 Successful voice acquisition was attained in 86% of patients within ten months, comparable to rates reported with primary TEP at the time of other forms of reconstruction. 5 Three patients did not achieve immediate tracheoesophageal voice acquisition.…”

Section: Discussionsupporting

confidence: 60%

“…9 Primary placement of the TEP may be deferred in patients deemed higher risk for poor wound healing capability, fear of prosthesis displacement, or patient preference. 8 In conclusion, SCAIF is becoming a widely adopted flap for reconstruction following TL or TLPP. Consideration and planning for voice acquisition remains a crucial part of the preoperative workup.…”

Section: Discussionmentioning

confidence: 99%

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Primary Tracheoesophageal Puncture with Supraclavicular Artery Island Flap after Total Laryngectomy or Laryngopharyngectomy

Sethi¹,

Kozin²,

Lam³

et al. 2014

Otolaryngol.--head neck surg.

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The supraclavicular artery island flap (SCAIF) is increasingly employed for laryngectomy reconstruction with excellent success. Although tracheoesophageal puncture (TEP) with intraoperative prosthesis placement is also positively reported, this is not described in patients following SCAIF. We review our experience with primary TEP with prosthesis placement and voice outcomes in patients after SCAIF reconstruction. Seven patients underwent SCAIF with primary TEP after laryngectomy from 2011-2013. Five underwent total laryngectomy (TL) and two underwent TL with partial pharyngectomy. All patients had 16 French Indwelling BlomSinger prostheses placed intra-operatively without complications. Six patients achieved tracheoesophageal voice (median time =1.5 months). Two patients required cricopharyngeal segment Botox© injections. One patient remained aphonic. One patient developed prosthesis leakage addressed with prosthesis replacement. Our preliminary data demonstrates that, similar to free tissue transfer reconstruction, primary TEP with intraoperative placement of the voice prosthesis at the time of SCAIF reconstruction is safe and effective.

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“…(7) Others have also described immediate placement of a voice prosthesis at the time of primary TEP, with successful restoration of voice. (12-13) We do, however, place a rubber catheter in the tract on the rare occasion that the procedure requires use of guidewire technique due to party wall collapse. The latter technique, which we previously described, has not been required in any case performed in the last 12 months.…”

Section: Discussionmentioning

confidence: 99%

Office-based tracheoesophageal puncture: Updates in techniques and outcomes

Bergeron¹,

Jamal²,

Erman³

et al. 2014

American Journal of Otolaryngology

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Purpose Tracheoesophageal Puncture (TEP) is an effective rehabilitation method for postlaryngectomy speech and has already been described as a procedure that is safely performed in the office. We review our long-term experience with office-based TEP over the past seven years in the largest cohort published to date. Materials and Methods A retrospective chart review was performed of all patients who underwent TEP by a single surgeon from 2005 through 2012, including office-based and operating room procedures. Indications for the chosen technique (office versus operating room) and surgical outcomes were evaluated. Results 59 patients underwent 72 TEP procedures, with 55 performed in the outpatient setting and 17 performed in the operating room, all without complication. The indications for performing TEP’s in the operating room included 2 primary TEP’s, 14 due to concomitant procedures requiring general anesthesia, and 1 due to failed attempt at office-based TEP. 19 patients with prior rotational or free flap reconstruction successfully underwent office-based TEP. Conclusions TEP in an office-based setting with immediate voice prosthesis placement continues to be a safe method of voice rehabilitation for postlaryngectomy patients, including those who have previously undergone free flap or rotational flap reconstruction. Office-based TEP is now our primary approach for postlaryngectomy voice rehabilitation.

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Evaluation of voice prosthesis placement at the time of primary tracheoesophageal puncture with total laryngectomy

Abstract: This study demonstrates that the voice prosthesis can be safely and effectively placed intraoperatively at the time of primary TEP and laryngectomy. Initial voice acquisition rates were high and long-term success was well within the acceptable range.

Cited by 34 publications

References 19 publications

Comparison between Primary and Secondary Tracheoesophageal Puncture Prosthesis: A Systematic Review

Comparison between Primary and Secondary Tracheoesophageal Puncture Prosthesis: A Systematic Review

Primary Tracheoesophageal Puncture with Supraclavicular Artery Island Flap after Total Laryngectomy or Laryngopharyngectomy

Office-based tracheoesophageal puncture: Updates in techniques and outcomes

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