title: Transnasal oesophagoscopy-guided in-office secondary tracheoesophageal puncture.
abstract: OBJECTIVE
  Tracheoesophageal puncture is recognised as an effective and reliable method for voice restoration following total laryngectomy. Several techniques have been described, ranging from rigid oesophagoscopy under general anaesthesia to more recent endoscopic techniques utilising intravenous sedation or local anaesthetic. We describe our technique for secondary tracheoesophageal puncture utilising unsedated transnasal oesophagoscopy in an office setting.
  
  
  METHODS
  Retrospective review of all total laryngectomy patients undergoing in-office transnasal oesophagoscopy-assisted tracheoesophageal puncture between October 1 2004 and December 31 2006.
  
  
  RESULTS
  Eleven patients undergoing transnasal oesophagoscopy-guided tracheoesophageal puncture were identified. Successful tracheoesophageal puncture placement was achieved in 10 of 11 patients (91 per cent). In one patient tracheoesophageal puncture could not be performed due to anatomic constraints. One patient had bleeding from the puncture site requiring silver nitrate cautery. All patients tolerated the procedure well. Voice results were satisfactory in all cases.
  
  
  CONCLUSIONS
  Transnasal oesophagoscopy-guided tracheoesophageal puncture provides a simple, safe option for secondary voice rehabilitation in laryngectomy patients.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California at Davis, Sacramento, California, USA.
authors.forename: V S
authors.initials: VS
authors.lastname: Doctor
authors.forename: D J
authors.initials: DJ
authors.lastname: Enepekides
authors.forename: D G
authors.initials: DG
authors.lastname: Farwell
authors.forename: P C
authors.initials: PC
authors.lastname: Belafsky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D014832:Voice Disorders / Q000534:rehabilitation*