In-office unsedated tracheoesophageal puncture

Area of Science:

• Otolaryngology
• Speech Rehabilitation
• Surgical Procedures

Background:

• Tracheoesophageal puncture (TEP) is a key method for voice restoration post-total laryngectomy.
• TEP can be performed at the time of laryngectomy (primary) or later (secondary).
• Secondary TEP offers voice restoration for patients who did not have primary TEP or had device failure.

Purpose of the Study:

• To review current literature on secondary in-office TEP techniques.
• To focus on TEP methods performable under local anesthesia.
• To assess the efficacy and safety of outpatient TEP procedures.

Main Methods:

• Literature review of secondary TEP techniques.
• Emphasis on procedures conducted in an office setting.
• Focus on techniques utilizing local anesthesia.

Main Results:

• Numerous secondary in-office TEP techniques exist, many requiring sedation.
• Transnasal esophagoscopy (TNE) is increasingly used in otolaryngology practices.
• TNE can guide TEP placement in an outpatient setting with local anesthesia.

Conclusions:

• In-office secondary TEP is increasingly common.
• TNE-guided TEP offers superior visualization during the procedure.
• Office-based TEP using local anesthetic is quick, safe, and effective.