Tracheoesophageal puncture enlargement in laryngectomized patients is a significant problem due to complications such as aspiration pneumonia. There are several management methods including conservative and nonconservative techniques. A total closure of the enlarged tracheoesophageal puncture is needed in some cases when conservative approaches have failed. At this point, the insertion of a sil...

OBJECTIVES To determine whether postoperative complication rates and speech outcomes differ between patients undergoing primary versus secondary tracheoesophageal puncture following total laryngectomy with free flap reconstruction. STUDY DESIGN Retrospective clinical study in a tertiary academic center. METHODS Between November 2004 and June 2010, 137 patients underwent total laryngectomy o...

OBJECTIVES To determine the success rate and relating clinical factors of voice prosthesis rehabilitation and to analyze the discrimination ability of the multidimensional Harrison-Robillard-Shultz Tracheoesophageal Puncture Rating Scale (HRS Rating Scale). DESIGN Prospective clinical study. SETTING University Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Ins...

Tracheoesophageal puncture is a simple procedure for speech rehabilitation of total laryngectomy patients. Despite its relative simplicity this is not an innocent technique without complications. The goal of this study was to determine the incidence of acute mediastinitis as an early postoperative complication related to this procedure and to present outcomes of non-surgical conservative manage...

OBJECTIVE To describe a novel use of flexible fiberoptic endoscopy to examine the pharyngoesophageal segment, upper esophagus, and distal end of the tracheoesophageal prosthesis in patients who have undergone a total laryngectomy and a tracheoesophageal puncture. METHODS Five patients with poor-quality or no tracheoesophageal voice were evaluated by a speech pathologist and an otolaryngologis...

Background: Functional speech rehabilitation after total laryngectomy remains one of the most challenging issues in head and neck multidisciplinary care. Tracheoesophageal puncture for voice prosthesis insertion performed as a secondary procedure with a rigid esophagoscope and trocar can be technically difficult in certain patients due to post-treatment cervical abnormalities, such as reduced h...

BACKGROUND A new device is described for secondary tracheoesophageal puncture (TEP). We hypothesize that the device can be used to create the puncture, size, and insert the voice prosthesis in antegrade fashion in a single procedure suitable for office-based use. METHODS A measurement and insertion device (MAID) was designed with the hypothesis in mind and tested on 3 pigs while they were und...

Introduction: Surgical procedures, especially total laryngectomy, have a profound adverse effect on the patient's physical, functional, as well as emotional health, and strongly decrease quality of life. Tracheoesophageal puncture is one of the most significant method that is widely performed successfully by physicians. Current valve technology enables long expiring duration; however, gen...

OBJECTIVES/HYPOTHESIS The purpose of this study was to determine the rate of complications in the immediate postoperative period following primary tracheoesophageal puncture (TEP) after salvage laryngectomy. STUDY DESIGN Retrospective. METHODS A retrospective review was done of 26 patients who underwent primary TEP with salvage total laryngectomy. To minimize variables, the patients include...