Secondary voice prosthesis insertion in patients without direct access to the upper esophagus

Meerwein, Christian; Laske, Roman D.; Castiglioni, Kristina; Bohlender, Jürgen; Huber, Gerhard

doi:10.1002/lary.24273

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…Present methods of secondary TEP are largely predicated on the successful insertion of a rigid esophagoscope. Due to poor cervical extension, radiation fibrosis, or esophageal strictures, advancing a rigid esophagoscope is often not technically feasible [3][4][5]. Contemporary efforts at organ preservation employ chemoradiation paradigms, so more laryngectomies are performed in the salvage setting after treatment.…”

Section: Introductionmentioning

confidence: 99%

A Novel Device for Placement of a Secondary Tracheoesophageal Voice Prosthesis: A Preliminary Feasibility Study

Tkaczuk¹,

Taylor²,

Wolf³

2018

ORL

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Background: Tracheoesophageal puncture (TEP) for post-laryngectomy speech rehabilitation can be performed at the time of laryngectomy (primary) or at a subsequent time (secondary). Traditionally, the secondary procedure is performed using a rigid esophagoscope. Diseases like esophageal stricture, limited neck extension, and soft-tissue fibrosis can make this procedure technically challenging or impossible. We developed a novel device to perform a secondary tracheoesophageal puncture using a flexible esophagoscope. Objective: To test the feasibility of a novel device used to create a secondary TEP in post-laryngectomy cadavers. Methods: In this study, we performed a total laryngectomy on 3 fresh cadavers to establish the feasibility of our prototype. In each cadaver, a flexible esophagoscope was passed into the pharynx with the prototype. The prototype was passed through a working port and deployed to distend the esophagus. The puncture was visualized and a wire was passed via the newly established fistula. The device was activated, securing the wire, and then the esophagoscope and device were removed. Results: There was 100% successful deployment of the prototype device, allowing rapid creation of the puncture and security of the guide wire in each cadaver. There was no evidence of collateral mucosal injury or esophageal perforation. Conclusions: The prototype device offers an alternative method to safely and efficiently perform a secondary TEP without the requirement of rigid esophagoscopy which can sometimes be technically impossible in this patient population.

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Section: Introductionmentioning

confidence: 99%