title: The hybrid tracheoesophageal puncture procedure: indications and outcomes.
abstract: OBJECTIVE
  This report aimed to describe a novel and efficient method of tracheoesophageal puncture using a hybrid device assembled from 2 commercially available puncture kits; to demonstrate the utility of this technique in the performance of primary and secondary procedures, under general and local anesthesia, with and without flap reconstruction; and to evaluate the efficacy of concurrent puncture and valve placement.
  
  
  METHODS
  Thirty-four patients who underwent either primary or secondary tracheoesophageal puncture for voice restoration. Charts were reviewed retrospectively for complications, time to first valve change, operative time, and blood loss.
  
  
  RESULTS
  Using this novel hybrid device, simultaneous puncture and valve placement was achieved in 34 consecutive patients. There was 1 major complication; blood loss was negligible; and the procedure could be accomplished in all cases. There were no cases of prosthesis failure as a result of the insertion technique.
  
  
  CONCLUSIONS
  Concurrent tracheoesophageal puncture and voice prosthesis placement is a simple and efficient method of voice restoration in the laryngectomized patient and can be more easily accomplished with a hybrid device assembled from the components of 2 commercially available puncture kits. It can be performed under local as well as general anesthesia. The procedure is adaptable to a variety of clinical situations.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Damrose
authors.forename: Do-Yeon
authors.initials: DY
authors.lastname: Cho
authors.forename: Richard L
authors.initials: RL
authors.lastname: Goode
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D011677:Punctures / Q000295:instrumentation / Q000379:methods*; D014132:Trachea / Q000601:surgery*; D055815:Young Adult