title: Outcomes of primary and secondary tracheoesophageal puncture: a 16-year retrospective analysis.
abstract: The current study retrospectively reviewed the cases of 68 patients who had undergone total laryngectomy and tracheoesophageal puncture (TEP) over a 16-year period. Fifty-one patients underwent primary TEP and 17 underwent secondary TEP. Nearly 80% of patients who received TEP at the time of laryngectomy achieved excellent voice quality perceptually. In contrast, only 50% of secondary TEP patients achieved excellent voice ratings. This difference was statistically robust (p = 0.03). Although both surgical and prosthesis-related complications occurred more frequently following primary TEP, statistically significant differences were not achieved. Neither pre- nor postoperative radiotherapy had any effect on voice restoration or complication rates. Based on these data, primary TEP may be preferable for several reasons, including a greater likelihood of successful voice restoration, a shorter duration of postoperative aphonia, and the elimination of the need for a second operation and interim tube feedings.
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York City, NY 10021, USA.
authors.forename: Elaine
authors.initials: E
authors.lastname: Cheng
authors.forename: Margie
authors.initials: M
authors.lastname: Ho
authors.forename: Cindy
authors.initials: C
authors.lastname: Ganz
authors.forename: Ashok
authors.initials: A
authors.lastname: Shaha
authors.forename: Jay O
authors.initials: JO
authors.lastname: Boyle
authors.forename: Bhuvanesh
authors.initials: B
authors.lastname: Singh
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wong
authors.forename: Snehal
authors.initials: S
authors.lastname: Patel
authors.forename: Jatin
authors.initials: J
authors.lastname: Shah
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Branski
authors.forename: Dennis H
authors.initials: DH
authors.lastname: Kraus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D007825:Laryngectomy; D007830:Larynx / Q000601:surgery; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011677:Punctures; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013071:Speech, Alaryngeal; D014132:Trachea / Q000601:surgery*; D016896:Treatment Outcome; D014833:Voice Quality