title: Does primary tracheoesophageal puncture reduce complications after laryngectomy and improve patient communication?
abstract: The charts of 96 patients who had a laryngectomy at the University of Minnesota and affiliated hospitals were reviewed to assess the benefit of primary tracheoesophageal puncture (TEP). Patients were stratified into those with primary TEP and those without. There was no statistical difference in rates of esophageal stenosis, stomal stenosis, or wound breakdown without fistula. No fistulas developed in 33 patients who received primary TEP. 52% Of those with primary TEP, used their prosthesis for speech long-term. Only 5 of 63 patients whose surgery did not include primary TEP, received a secondary TEP, and only 2 retained the prosthesis for speech. There was no increased morbidity or incidence of complications after laryngectomy when performing a primary TEP. Patients will maintain the initial form of speech rehabilitation, even if it is less comprehensible. The early postoperative period is convenienced by using the puncture site as the entrance for nutrition during wound healing.
authors.affiliation: Sheppard Air Force Base, TX, USA.
authors.forename: R G
authors.initials: RG
authors.lastname: Karlen
authors.forename: R H
authors.initials: RH
authors.lastname: Maisel
mesh_terms: D003142:Communication; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011677:Punctures / Q000295:instrumentation*; D012189:Retrospective Studies; D013060:Speech; D013071:Speech, Alaryngeal; D013072:Speech, Esophageal; D013524:Surgical Flaps; D014132:Trachea / Q000601:surgery*; D014834:Voice Training