title: Cymetra injections to treat leakage around a tracheoesophageal puncture.
abstract: Tracheoesophageal puncture (TEP) is a commonly used method of voice restoration following total laryngectomy, but leakage around the prosthesis is prevalent. Several treatments for leakage have been proposed in the literature, but with varying success. This paper examines the efficacy of Cymetra to help shrink the TEP site and stop leakage. Six patients with leaking TEP sites refractory to downsizing and/or cautery were selected for the study. Injection sites were determined based on the primary sites of leakage. Cymetra was rehydrated with 1.0 % lidocaine saline solution and injected via a 23-gauge needle a few millimeters deep to the mucosa, approximately 2 mm from the edge. The patients were followed for up to 13 months. Following 1 trial of Cymetra injection, 4 patients achieved successful results. Only 1 patient has not yet achieved full resolution of leakage. Cymetra may provide a safer and more effective option for resolution of leakage than other methods currently employed.
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. meena.seshamani@marshallscholarship.org
authors.forename: Meena
authors.initials: M
authors.lastname: Seshamani
authors.forename: Cesar
authors.initials: C
authors.lastname: Ruiz
authors.forename: Sandra
authors.initials: S
authors.lastname: Kasper Schwartz
authors.forename: Natasha
authors.initials: N
authors.lastname: Mirza
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003094:Collagen / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods*; D007825:Laryngectomy / Q000534:rehabilitation; D007831:Larynx, Artificial / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: C471832:Cymetra; D003094:Collagen