title: Primary TEP placement in patients with laryngopharyngeal free tissue reconstruction and salivary bypass tube placement.
abstract: The authors examined the feasibility and advantages of primary tracheoesophageal puncture (TEP) with intraoperative placement of the voice prosthesis for patients undergoing laryngopharyngectomy requiring free tissue reconstruction and salivary bypass tube placement. Six patients were identified; 4 underwent total laryngopharyngectomy, and 2 underwent total laryngectomy with partial pharyngectomy. All 6 required free tissue reconstruction, and a salivary bypass tube was placed in all cases. All patients had a 20F Indwelling Blom-Singer prosthesis (InHealth Technologies, Carpinteria, California) placed. No complications were noted with intraoperative prosthesis placement. No prostheses were dislodged in the postoperative period. At 6 months, 4 patients available for evaluation had successful voice outcomes, and 3 were disease free. This study demonstrates the effectiveness of voice prosthesis placement at the time of primary TEP associated with free tissue reconstruction of a laryngopharyngeal defect with salivary bypass tube placement.
authors.affiliation: Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA. vasudivi@med.umich.edu
authors.forename: Vasu
authors.initials: V
authors.lastname: Divi
authors.forename: Derrick T
authors.initials: DT
authors.lastname: Lin
authors.forename: Kevin
authors.initials: K
authors.lastname: Emerick
authors.forename: James
authors.initials: J
authors.lastname: Rocco
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Deschler
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004750:Enteral Nutrition; D004947:Esophagus / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy; D019919:Prosthesis Implantation / Q000379:methods*; D011677:Punctures; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery*