Tracheo Oesophageal Puncture Voice: An Indian Perspective

Abstract

Author presents in this study 160 patients who underwent tracheoesophageal puncture (TEP) for voice rehabilitation after laryngectomy. This study represents authors experience in Indian perspective with regards to technique, timing of surgery, i.e., primary or secondary, effect of socioeconomic condition of the patients. Author also narrated complications secondary to the TEP voice and prosthesis, during long follow-up of 15 years. The primary and secondary TEP were compared in patients having good socio-economical status with that of relatively poor status patients. As compared to the western literature, this Indian study showed significant differences in success rate of achieving good TEP voice production and also continuing use of TEP voice. Author observed that despite, entirely different socio economic condition and lack of proper follow-up, the secondary TEP done after complete evaluation of the patient yields much better sustained results for successful voice acquisition and continuation of the use of acquired voice. Author has described in details about the surgical procedures for secondary TEP; the prosthesis, care of prosthesis, problems due to TEP and prosthesis and the ways to rectify these problems.

Voice prosthesis experience of Indian laryngectomees: Preliminary findings from a tertiary hospital in South India

“…The response from most of the participants indicated that the leakage was not a major issue or that it was quite tolerable. This finding aligns with another Indian study, 21 where it was stated that financial constraint was a major factor for most patients and that many tolerated minor leakages and came for replacement only when the leakage became intolerable. The trend in the west is that patients are prompt in replacing the voice prosthesis as they do not tolerate even the slightest leakage as it can lead to further medical complications such as pneumonia or other chronic lower respiratory tract infections.…”

“…Tone, being a perceptual attribute of the fundamental frequency, becomes more relevant in the characterization of voice in female TE speakers. This aspect has been discussed in an Indian study, 21 in which the author observed that 30% of TE speakers disliked their voice quality and often felt it lacked sexual characterization. Since all the participants in our study were males, a low-pitched voice was considered satisfactory.…”

Comparação entre a punção primária e secundária da prótese fonatória traqueoesofágica: uma revisão sistemática

“…Esta metanálise não demonstrou qualquer desvantagem na sua colocação no mesmo momento da laringectomia total comparado com a população na qual essa abordagem não foi utilizada. 25 .…”