title: Submucosal purse-string suture as a treatment of leakage around the indwelling voice prosthesis.
abstract: BACKGROUND
  Leakage around the indwelling voice prosthesis is an annoying complication of tracheoesophageal speech.
  
  
  METHODS
  Twenty patients, who experienced peripheral leakage of the tracheoesophageal fistula, were treated with a purse-string suture. Our aim was to get the patients free of leakage without losing their voice prosthesis. The technique was considered successful if this objective was reached and unsuccessful if eventually closure of the fistula was required.
  
  
  RESULTS
  Immediately after the procedure, no patients showed residual leakage. At 1 month, 2 patients experienced recurrent leakage. At a mean follow-up of 19.4 months, the method was successful in 16 patients and unsuccessful in 4 patients.
  
  
  CONCLUSIONS
  If peripheral leakage is not amenable to simple downsizing of the indwelling voice prosthesis, we feel the purse-string suture is the first-choice treatment because of its safety, efficiency, low cost, and ease of application.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Leuvens Kanker Instituut, University Hospitals Sint-Rafaël and Gasthuisberg, Leuven, Belgium.
authors.forename: Kristien
authors.initials: K
authors.lastname: Jacobs
authors.forename: Pierre R
authors.initials: PR
authors.lastname: Delaere
authors.forename: Vincent L M
authors.initials: VL
authors.lastname: Vander Poorten
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007820:Laryngeal Mucosa / Q000601:surgery; D007825:Laryngectomy; D007831:Larynx, Artificial / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017755:Prosthesis Fitting; D012008:Recurrence; D013536:Suture Techniques; D014138:Tracheoesophageal Fistula / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome