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Primary tracheoesophageal puncture and cricopharyngeal myotomy in stapler-assisted total laryngectomy

Published online by Cambridge University Press:  26 May 2016

D M Beswick  and
E J Damrose
D M Beswick
Affiliation:
Department of Otolaryngology / Head and Neck Surgery, Stanford University School of Medicine, California, USA
E J Damrose*
Affiliation:
Department of Otolaryngology / Head and Neck Surgery, Stanford University School of Medicine, California, USA
*
Address for correspondence: Dr Edward J Damrose, Department of Otolaryngology / Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA Fax: +1 650 725 8502 E-mail: [email protected]
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Abstract

Objective:

To evaluate the utility of the hybrid tracheoesophageal puncture procedure in stapler-assisted laryngectomy.

Methods:

Patients who underwent total laryngectomy at a single institution from 2009 to 2015 were reviewed. The interventions assessed were surgical creation of a tracheoesophageal puncture and placement of a voice prosthesis. The outcomes measured included voicing ability and valve failure.

Results:

Thirty-nine patients underwent total laryngectomy or pharyngolaryngectomy. Of these, nine underwent stapler-assisted laryngectomy; seven of the nine patients underwent concurrent stapler-assisted laryngectomy, cricopharyngeal myotomy and a hybrid tracheoesophageal puncture procedure. These seven patients were the focus of this review. Successful voicing and oral alimentation was achieved in all patients. Mean time to phonation was 30 days (range, 7–77 days) and mean time to first valve change was 90 days (range, 35–117 days).

Conclusion:

Primary tracheoesophageal puncture with concurrent voice prosthesis placement and cricopharyngeal myotomy is easily performed with stapler-assisted laryngectomy. The hybrid tracheoesophageal puncture procedure is a simple method that enables a single operator to achieve primary tracheoesophageal puncture and valve placement; in addition, it facilitates concurrent cricopharyngeal myotomy.

Keywords

LarynxLaryngectomySurgical StaplersPuncturesVoiceNeoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 7 , July 2016 , pp. 686 - 690
Copyright
Copyright © JLO (1984) Limited 2016 

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Footnotes

Presented at the Combined Otolaryngology Spring Meetings, 14–18 May 2014, Las Vegas, Nevada, USA.

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