Flexible endoscopic tracheo-oesophageal puncture under local anaesthetic.
Blom-Singer valve prosthesis is an increasingly popular technique for voice rehabilitation in alaryngeal patients. Although primary voice puncture is being practised, the creation of the tracheo-oesophageal fistula is performed in the majority of patients as a secondary procedure. We describe a technique of secondary tracheo-oesophageal puncture using the flexible endoscope which can be performed under local anaesthetic and sedation. The technique overcomes the difficulty of passing a rigid oesophagoscope or forceps to the level of the tracheostome in a scarred and irradiated neck. The new technique also obviates the need for general anaesthesia. We have successfully used the technique in three patients.
Hong
G S
GS
Department of Surgery, Singapore General Hospital, Singapore.
John
A B
AB
Theobald
D
D
Soo
K C
KC
D000772:Anesthesia, Local; D004947:Esophagus; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007831:Larynx, Artificial; D011677:Punctures / Q000379:methods*; D014132:Trachea