title: Secondary tracheoesophageal puncture and myotomy--A novel outpatient technique.
abstract: BACKGROUND
  The purpose of this study was to show a novel technique for secondary tracheoesophageal puncture (TEP) and myotomy in patients who previously underwent total laryngectomy.
  
  
  METHODS
  Fifteen patients underwent secondary TEP and 3 patients underwent myotomy. In 1 patient, both myotomy and TEP were done concurrently. A Foley catheter is nasally inserted into the esophagus with the patient under local anesthesia and the catheter balloon is inflated at the site of the planned procedure. The myotomy is performed over the inflated balloon for esophageal posterior wall protection and a voice prosthesis is inserted in a small incision made by the physician. When only myotomy is performed, the muscles over the mucosa are incised. A voice test is performed immediately.
  
  
  RESULTS
  All patients exhibited good voice rehabilitation. One patient who had a myotomy had a penetration of the pharyngeal mucosa with immediate closure and no sequelae.
  
  
  CONCLUSIONS
  Outpatient Foley catheter-guided myotomy and secondary TEP are simple, safe, time saving, and cost-effective procedures.
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.
authors: Shay I
authors: SI
authors: Duvdevani
authors: Yoav P
authors: YP
authors: Talmi
authors: Zeev
authors: Z
authors: Horowitz
authors: Michael
authors: M
authors: Wolf
authors: Lev
authors: L
authors: Bedrin
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D002404:Catheterization; D004947:Esophagus / Q000601:surgery*; D006801:Humans; D007825:Laryngectomy; D007831:Larynx, Artificial; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010609:Pharyngeal Muscles / Q000601:surgery*; D011677:Punctures / Q000379:methods*; D013748:Tetracaine / Q000008:administration & dosage; D014132:Trachea / Q000601:surgery*; D014833:Voice Quality
chemical_list: D000779:Anesthetics, Local; D013748:Tetracaine; D008012:Lidocaine; D002045:Bupivacaine