Improved Tracheoesophageal Prosthesis Sizing in Office-Based Tracheoesophageal Puncture

Abstract

Voice prosthesis sizing was better in patients who had office-based TEP than in patients who had operating room-based TEP. This outcome is likely due to the lesser degree of swelling of the tracheoesophageal party wall in the office-based procedure.

Office-based procedures for diagnosis and treatment of esophageal pathology

“…A dilator is placed over the guidewire to create a proper fistula. 64,85,[91][92][93][94][95][96] Some authors left the catheter in place within the fistula to mature, ranging from 1 to 14 days. 85,86,90,93,[96][97][98][99] Although, there are authors who placed the voice prosthesis directly after the fistula was created.…”

Total laryngectomy with primary tracheoesophageal puncture: Intraoperative versus delayed voice prosthesis placement

“…This TEP can be created at either the time of the surgery (primary TEP) or at a later timepoint postsurgery (secondary TEP). Both methods are well established in the literature and are documented as safe and reliable procedures, resulting in comparable patient outcomes and minimal complications …”

Office-based tracheoesophageal puncture: Updates in techniques and outcomes

“…We have previously published the benefits of immediate prosthesis placement, including improved prosthesis sizing and fewer prosthesis replacements needed before achieving stable prosthesis length. (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.…”

“…(7) Of note, the techniques of the procedure have evolved over the study period with a few important changes, highlighted below. First, the nasal cavity is anesthetized and decongested with topical 4% lidocaine and 1% neosynephrine.…”