title: The missing tracheoesophageal puncture prosthesis: evaluation and management.
abstract: Placement of a tracheoesophageal puncture prosthesis in the post-laryngectomy patient has significantly improved voice rehabilitation in this population. Rarely, the prosthesis may become dislodged, necessitating medical evaluation. We present the case of a 61-year-old man who presented to our Emergency Department with a missing prosthesis. We describe the evaluation and management of this patient and review the relevant literature. We conclude with the following algorithm: When a patient presents with a missing prosthesis, evaluation of the tracheobronchial tree must be performed. Once the pulmonary system is cleared, the prosthesis can be presumed in the gastrointestinal tract and allowed to pass. A new prosthesis or catheter should be placed in the tract to prevent aspiration.
authors: Division of Pediatric Otolaryngology, Rady Children's Hospital, San Diego, CA 92123, USA. sleuin@rchsd.org
authors: Shelby C
authors: SC
authors: Leuin
authors: Daniel G
authors: DG
authors: Deschler
mesh_terms: D000465:Algorithms; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003937:Diagnosis, Differential; D005548:Foreign-Body Migration / Q000175:diagnosis*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011475:Prosthesis Failure; D013270:Stomach; D014057:Tomography, X-Ray Computed