Tissue augmentation treatment for periprosthetic leakage in patients who have undergone a total laryngectomy: A systematic review

Abstract

Objectives: Tracheoesophageal puncture (TEP) is considered the gold standard for voice rehabilitation after total laryngectomy. One of the main causes of treatment failure, and a potentially serious complication, is the TEP enlargement and/or leakage around the voice prosthesis. The injection of biocompatible material to increase the volume of the puncture surrounding tissue has been studied as a popular option for conservative treatment of enlarged tracheoesophageal fistula. The aim of this paper was to perform a systematic review of the efficacy and safety of such treatment. Desingn: Search conducted in PubMed/MEDLINE, the Cochrane Library, Google Scholar, Scielo and Web of Science and through the meta-searcher Trip Database based on Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) statement.Miguel Mayo-Yáñez and Mercedes Díaz Ramos-Neble contributed equally to the study and have to be joined as co-senior authors.

Evidence-Based Recommendations in Primary Tracheoesophageal Puncture for Voice Prosthesis Rehabilitation

“…Other frequently used techniques include temporary removal of the VP, circular suture of the fistula, or tissue augmentation with the injection around the fistula of different materials (collagen, bioplastics, autologous fat, hyaluronic acid…). These methods aim to reduce the diameter of the fistula [ 87 , 98 ] (4, C). Closing the tracheoesophageal fistula by placing a silicone prosthesis or surgically are alternatives when conservative options have failed [ 99 ].…”

“….). These methods aim to reduce the diameter of the fistula [87,98] (4, C). Closing the tracheoesophageal fistula by placing a silicone prosthesis or surgically are alternatives when conservative options have failed [99].…”

Cost-Effectiveness Study of Double-Flange Voice Prostheses in the Treatment of Periprosthetic Leakage in Laryngectomized Patients

“…Various treatments have been proposed, including surgical closure of the TEP, which would eliminate problems associated with leakage around the prosthesis, but would also prevent voice production, negatively affecting the patient's quality of life. Therefore, conservative methods, both surgical and non-surgical, that aim to eliminate leaks around the VP, while preserving functional voice, have gained interest over the years [10][11][12]. Although various conservative treatments have been proposed, clear guidelines for the management of this complication do not exist to date [13][14][15].…”