title: Flexible endoscopic tracheo-oesophageal puncture under local anaesthetic.
abstract: 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.
authors.affiliation: Department of Surgery, Singapore General Hospital, Singapore.
authors.forename: G S
authors.initials: GS
authors.lastname: Hong
authors.forename: A B
authors.initials: AB
authors.lastname: John
authors.forename: D
authors.initials: D
authors.lastname: Theobald
authors.forename: K C
authors.initials: KC
authors.lastname: Soo
mesh_terms: D000772:Anesthesia, Local; D004947:Esophagus; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007831:Larynx, Artificial; D011677:Punctures / Q000379:methods*; D014132:Trachea