title: Complications of tracheoesophageal puncture and speech valves: retrospective analysis of 47 patients.
abstract: OBJECTIVE
  This study aims to evaluate the complications of tracheoesophageal puncture (TEP) for voice restoration and speech valves in patients undergoing total laryngectomy.
  
  
  METHODS
  Between January 2006 and June 2011, 47 male patients (mean age 62.8±1.2 years; range 41 to 80 years) who underwent TEP and speech valve for voice restoration after total laryngectomy were retrospectively analyzed. Secondary TEP was performed and Provox indwelling voice prosthesis were inserted in all patients. Demographic, disease and treatment characteristics of patients were recorded. Complications related to TEP and speech valves, the management of complications and clinical conditions of complete closure of TEP were also recorded.
  
  
  RESULTS
  Tracheoesophageal puncture and speech valve related complications were observed in 20 patients. The majority of complications were minor complications including granulation tissue formation (n=2, 4.2%), deglutition of prosthesis (n=6, 12.7%) and TEP enlargement/leakage around prosthesis (n=9, 19.1%). Major complications were observed in three patients. Two of them were life-threatening complications; a mediastinitis (n=1, 3.1%) and paraesophageal abscess (n=1, 3.1%), and both appeared in the first month of the postoperative period. The overall complication rate was 42.6% during mean follow-up of 15.3 months. Tracheoesophageal fistula enlargement (n=9, 19.1%) was the most common minor complication and the most common cause of complete closure of TEP in this study.
  
  
  CONCLUSIONS
  Tracheoesophageal puncture for voice restoration is not an entirely innocent procedure without any complications. Patients should be monitored for TEP-related complications in the early and late postoperative period.
authors.affiliation: Department of Otolaryngology, İzmir Atatürk Training and Research Hospital, Turkey. kadir_imre@yahoo.com
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Imre
authors.forename: Ercan
authors.initials: E
authors.lastname: Pınar
authors.forename: Cağlar
authors.initials: C
authors.lastname: Callı
authors.forename: Engin Umut
authors.initials: EU
authors.lastname: Sakarya
authors.forename: Sedat
authors.initials: S
authors.lastname: Oztürkcan
authors.forename: Semih
authors.initials: S
authors.lastname: Oncel
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Katılmış
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary / Q000601:surgery; D004947:Esophagus / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000556:secondary; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D007831:Larynx, Artificial / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000009:adverse effects*; D012189:Retrospective Studies; D013072:Speech, Esophageal / Q000379:methods; D014132:Trachea / Q000601:surgery*