title: In-office unsedated tracheoesophageal puncture.
abstract: OBJECTIVE
  Tracheoesophegeal puncture is a reliable and effective method for voice restoration after total laryngectomy. Tracheoesophegeal puncture may be performed primarily at the time of laryngectomy or as a secondary procedure. This paper reviews the current literature on secondary in-office tracheoesophegeal puncture techniques with an emphasis on techniques that can be performed under local anesthesia.
  
  
  RESULTS
  Many techniques for secondary in-office tracheoesophegeal puncture have been described. The majority require some form of intravenous sedation. Transnasal esophagoscopy is now performed routinely in many otolaryngology practices, and can be used to guide tracheoesophegeal puncture placement in an outpatient setting under local anesthesia.
  
  
  CONCLUSIONS
  In-office secondary tracheoesophegeal puncture has become more common in recent years. Transnasal esophagoscopy-guided tracheoesophegeal puncture provides excellent visualization of the operative site throughout the procedure. It can be performed quickly, safely, and effectively in an office setting utilizing only local anesthetic.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California at Davis, Sacramento, California, USA. vishaldr@stanfordalumni.org
authors.forename: Vishal S
authors.initials: VS
authors.lastname: Doctor
mesh_terms: D000556:Ambulatory Surgical Procedures; D004947:Esophagus / Q000601:surgery*; D006801:Humans; D007825:Laryngectomy; D011677:Punctures / Q000379:methods*; D014132:Trachea / Q000601:surgery*