Voice prosthesis related expanding tracheoesophageal puncture repair: microsurgical reconstruction to pedicled pectoralis major muscle flap

Daya, Mahendra; Pillay, Desigan

doi:10.17159/2078-5151/2018/v56n4a2336

Cited by 1 publication

(3 citation statements)

References 11 publications

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“…1 ). 9 10 11 13 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 Using the OCEBM, 33 studies had a level of evidence of 4. No discrepancies during quality assessment occurred.…”

Section: Resultsmentioning

confidence: 99%

“…A butterfly cartilage autograft to enforce TEP closure is an acceptable alternative that can be performed under local anesthesia and is associated with low morbidity. 42 This technique is elaborately described by Yenigun et al who reported that enteral feeding was resumed in a short span of time. 42 Likewise, FL autograft is also described as an excellent method for three-layered fistula closure.…”

Section: Discussionmentioning

confidence: 99%

“…42 This technique is elaborately described by Yenigun et al who reported that enteral feeding was resumed in a short span of time. 42 Likewise, FL autograft is also described as an excellent method for three-layered fistula closure. 44 The FL is a strong and easily harvestable autograft, capable of providing large amounts of reliable graft material; however, scar/keloid formation, hematoma, infection, and chronic pain (from the herniated muscle belly) can occur if proper donor site closure is not ensured.…”

Section: Discussionmentioning

confidence: 99%

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Definitive Closure of the Tracheoesophageal Puncture Site after Oncologic Laryngectomy: A Systematic Review and Meta-Analysis

et al. 2022

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Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure.A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed.Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1–13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1–43%), 7% (95% CI < 1–34%) for dermal graft interposition, < 1% (95% CI < 1–37%) for radial forearm free flap, < 1% (95% CI < 1–52%) for ligation of the fistula, 17% (95% CI < 1–64%) for interposition of a deltopectoral flap, 9% (95% CI < 1–28%) for primary closure, and 2% (95% CI < 1–20%) for interposition of a sternocleidomastoid muscle flap.Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

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