Outcomes of primary and secondary tracheoesophageal puncture: a 16-year retrospective analysis.
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.
Cheng
Elaine
E
Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York City, NY 10021, USA.
Ho
Margie
M
Ganz
Cindy
C
Shaha
Ashok
A
Boyle
Jay O
JO
Singh
Bhuvanesh
B
Wong
Richard J
RJ
Patel
Snehal
S
Shah
Jatin
J
Branski
Ryan C
RC
Kraus
Dennis H
DH
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