How I do it: modified lichtenberger-brown tracheoesophageal puncture procedure

Area of Science:

• Otolaryngology
• Speech and Voice Restoration
• Surgical Techniques

Background:

• Tracheoesophageal puncture (TEP) with prosthesis is standard for voice restoration post-laryngectomy.
• Various TEP approaches exist, each with distinct advantages and risks.

Purpose of the Study:

• To introduce and evaluate a novel, simplified TEP technique.
• To minimize complications and tissue trauma associated with traditional methods.

Main Methods:

• A retrospective review of patients undergoing TEP using a novel technique involving a modified needle carrier and retrograde prosthesis insertion.
• No rigid endoscope was used; visualization relied on palpation through the stoma.
• The procedure involved guiding an instrument through the mouth to the neopharynx/esophagus.

Main Results:

• Successful voice prosthesis placement in 14 laryngectomees, with 18 procedures performed.
• One instance of misplacement was noted.
• No other early or late complications related to TEP or prosthesis were observed.

Conclusions:

• The novel TEP technique simplifies the procedure, reducing reliance on risk-bearing instruments like rigid endoscopes.
• It aims to decrease tissue trauma and simplify the required surgical armamentarium.
• Initial clinical experience suggests usefulness in both standard and challenging anatomical cases.