Protocolized awake secondary tracheoesophageal puncture with immediate voicing

Area of Science:

• Otolaryngology
• Surgical Techniques
• Vocal Rehabilitation

Background:

• Tracheoesophageal (TE) puncture with voice prosthesis placement is a standard vocal rehabilitation method post-total laryngectomy.
• Traditional secondary TE puncture is performed in the operating room, often requiring general anesthesia and posing technical challenges.

Purpose of the Study:

• To describe a standardized, kit-based, awake, in-office technique for secondary TE puncture and primary voice prosthesis (TEP) placement.
• To provide a video tutorial of the described procedure, addressing the current lack of visual resources for this technique.

Main Methods:

• A kit-based, awake, in-office secondary TE puncture technique is detailed.
• The procedure involves 10 steps, from analgesia to voicing, with an endoscopic snare available for guidewire passage difficulties.

Main Results:

• The described technique facilitates in-office secondary TE puncture, potentially reducing risks associated with general anesthesia and lowering costs.
• A comprehensive video tutorial is presented to guide surgeons through the 10-step procedure.

Conclusions:

• The described kit-based, awake, in-office secondary TE puncture technique offers a standardized and advantageous approach to vocal rehabilitation after laryngectomy.
• This method provides a valuable, accessible alternative to traditional operating room procedures, enhancing patient care and potentially reducing healthcare costs.