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Office-based tracheoesophageal puncture: updates in techniques and outcomes
Jennifer L Bergeron1, Nausheen Jamal2, Andrew Erman3
1Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.
American Journal of Otolaryngology
|June 2, 2014
Summary
Office-based tracheoesophageal puncture (TEP) is a safe and effective voice rehabilitation method for patients after laryngectomy. This approach, even for those with prior flap reconstruction, is now the preferred primary method.
Area of Science:
- Otolaryngology
- Speech Rehabilitation
- Surgical Procedures
Background:
- Laryngectomy necessitates speech rehabilitation.
- Tracheoesophageal puncture (TEP) is an established method for post-laryngectomy voice restoration.
- Office-based procedures offer potential advantages in safety and efficiency.
Purpose of the Study:
- To review long-term outcomes of office-based tracheoesophageal puncture (TEP).
- To evaluate the safety and efficacy of TEP in an outpatient setting.
- To assess TEP feasibility in patients with prior reconstructive surgery.
Main Methods:
- Retrospective chart review of TEP procedures performed between 2005 and 2012.
- Analysis of indications for office-based versus operating room TEP.
- Evaluation of surgical outcomes and complications.
Main Results:
- 72 TEP procedures were performed on 59 patients; 55 were in the office setting.
- All procedures, including 19 in patients with prior flap reconstruction, were completed without complication.
- Operating room TEP was reserved for primary cases, procedures with general anesthesia, or failed office attempts.
Conclusions:
- Office-based TEP is a safe and effective voice rehabilitation technique for post-laryngectomy patients.
- TEP can be successfully performed in patients with prior free or rotational flap reconstruction.
- Office-based TEP is now the primary approach for voice rehabilitation in this patient population.
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