How I do it: closure of tracheoesophageal puncture site.
BACKGROUND
Tracheoesophageal voice prosthesis is highly effective in providing speech after total laryngectomy. Although it is a safe method, tracheoesophageal fistulas occasionally need to be closed, usually at the request of the patient, because of leakage through an enlarging fistula. We present our technique for closure of tracheoesophageal fistula.


METHODS
An incision is made at the mucocutaneous junction of the stoma from the 9 to the 3-o'clock position. Tracheoesophageal space is dissected down to and beyond the fistula. The tracheoesophageal tract is divided. The esophageal mucosa is closed with inverted sutures. After multiple layer closure of the esophageal fistula, the tracheal mucosa is closed with everted sutures.


RESULTS
This technique has been used in nine patients. Eight were successful. The remaining patient had radiation therapy failure.


CONCLUSIONS
This method of closure is simple and effective for those patients who require permanent closure of the tracheoesophageal fistula.
Hosal
S A
SA
Department of Otolaryngology, Hacettepe University School of Medicine, Ankara, Turkey.
Myers
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EN
D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D007831:Larynx, Artificial; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011677:Punctures; D012680:Sensitivity and Specificity; D014138:Tracheoesophageal Fistula / Q000601:surgery*; D014139:Tracheostomy / Q000379:methods*; D014945:Wound Healing