title: New method for in-office secondary voice prosthesis insertion under local anesthesia by reverse puncture from esophageal lumen.
abstract: OBJECTIVE
  We clarify and demonstrate the utility of our new method of voice prosthesis insertion using puncture from the esophageal lumen.
  
  
  METHODS
  Our new reverse puncture method using a flexible endoscope can be performed in an outpatient clinic under local anesthesia. We conducted a clinical trial with patients with head and neck cancer between April 2010 and February 2012. Our study focused on the following three points: 1) the percentage of patients for whom the procedure was successful; 2) the duration of the operation; and 3) any adverse effects.
  
  
  RESULTS
  The puncture was performed successfully for 21 of 22 patients (95%). The mean duration of the operation, excluding the time for local anesthesia, was only 11.6 minutes. All patients began voice rehabilitation and attained peroral intake immediately after the operation. None of the patients suffered complications from the procedures.
  
  
  CONCLUSIONS
  Most patients were treated with our new method with ease and at low risk. The high success rate and the absence of complications demonstrate the benefits of our method. We conclude that our method can be recommended for secondary reverse tracheoesophageal puncture.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Kazunori
authors.initials: K
authors.lastname: Fujiwara
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nomura
authors.forename: Naritomo
authors.initials: N
authors.lastname: Miyake
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kitano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000379:methods; D000772:Anesthesia, Local / Q000379:methods; D004947:Esophagus / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007825:Laryngectomy; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019919:Prosthesis Implantation / Q000379:methods*; D014132:Trachea / Q000601:surgery; D055815:Young Adult