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Voice restoration after total laryngectomy (TL) using tracheoesophageal puncture (TEP) showed high complication and low utilization rates. Secondary TEP may improve outcomes by allowing more patient counseling and healing time.

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post‐laryngectomy speechprimary tracheoesophageal puncturesecondary tracheoesophageal puncturetotal laryngectomytracheoesophageal puncture (TEP)voice rehabilitation

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Area of Science:

  • Otolaryngology
  • Speech Rehabilitation
  • Surgical Outcomes

Background:

  • Tracheoesophageal puncture (TEP) is a standard voice restoration method post-total laryngectomy (TL).
  • Understanding TEP outcomes in diverse patient populations is crucial for optimizing rehabilitation strategies.

Purpose of the Study:

  • To evaluate TEP outcomes, including utilization and complication rates, in a cohort of total laryngectomy patients.
  • To identify factors influencing TEP utilization and complications.
  • To compare outcomes between primary and secondary TEP placement.

Main Methods:

  • Retrospective analysis of 226 patients undergoing TEP between 2013 and 2020 at a tertiary hospital.
  • Data collected on TEP placement (primary/secondary), utilization, complications, and patient demographics.
  • Statistical analysis to identify factors associated with TEP utilization and complications.

Main Results:

  • TEP was performed primarily in 79%, secondarily in 6%, and not placed in 15% of patients.
  • Overall TEP utilization was 53.4% (52% primary, 71.4% secondary).
  • TEP-related complications occurred in 50.8% of patients; secondary TEP was less common in Black patients and more common with pharyngectomy. Older age and complications decreased utilization.

Conclusions:

  • This study in a lower socioeconomic status TL population revealed high complication and low overall TEP utilization rates.
  • Secondary TEP placement may be advantageous, potentially allowing for enhanced pre-operative counseling and improved patient healing.
  • Further research is needed to refine TEP protocols and improve voice rehabilitation success rates.