Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T03:21:12.429Z Has data issue: false hasContentIssue false
  • English
  • Français

Transnasal oesophagoscopy-guided in-office secondary tracheoesophageal puncture

Published online by Cambridge University Press:  26 July 2007

V S Doctor ,
D J Enepekides ,
D G Farwell  and
P C Belafsky
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Tracheoesophageal puncture is recognised as an effective and reliable method for voice restoration following total laryngectomy. Several techniques have been described, ranging from rigid oesophagoscopy under general anaesthesia to more recent endoscopic techniques utilising intravenous sedation or local anaesthetic. We describe our technique for secondary tracheoesophageal puncture utilising unsedated transnasal oesophagoscopy in an office setting.

Method:

Retrospective review of all total laryngectomy patients undergoing in-office transnasal oesophagoscopy-assisted tracheoesophageal puncture between October 1 2004 and December 31 2006.

Results:

Eleven patients undergoing transnasal oesophagoscopy-guided tracheoesophageal puncture were identified. Successful tracheoesophageal puncture placement was achieved in 10 of 11 patients (91 per cent). In one patient tracheoesophageal puncture could not be performed due to anatomic constraints. One patient had bleeding from the puncture site requiring silver nitrate cautery. All patients tolerated the procedure well. Voice results were satisfactory in all cases.

Conclusions:

Transnasal oesophagoscopy-guided tracheoesophageal puncture provides a simple, safe option for secondary voice rehabilitation in laryngectomy patients.

Keywords

Larynx NeoplasmsLaryngectomyVoiceOesophagusEndoscopyTracheoesophageal Puncture
Type
Rapid Communication
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 3 , March 2008 , pp. 303 - 306
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Singer, MI, Blom, ED. An endoscopic technique for restoration of voice after laryngectomy. Ann Otol Rhinol Laryngol 1980;89:529–3310.1177/000348948008900608CrossRefGoogle ScholarPubMed
2 Cheng, E, Ho, M, Ganz, C, Shaha, A, Boyle, JO, Singh, B et al. Outcomes of primary and secondary tracheoesophageal puncture: a 16-year retrospective analysis. Ear Nose Throat J 2006;85:262:264–710.1177/014556130608500417CrossRefGoogle ScholarPubMed
3 Chone, CT, Gripp, FM, Spina, AL, Crespo, AN. Primary versus secondary tracheoesophageal puncture for speech rehabilitation in total laryngectomy: long-term results with indwelling voice prosthesis. Otolaryngol Head Neck Surg 2005;133:89–9310.1016/j.otohns.2005.02.014CrossRefGoogle ScholarPubMed
4 Kao, WW, Mohr, RM, Kimmel, CA, Getch, C, Silverman, C. The outcome and techniques of primary and secondary tracheoesophageal puncture. Arch Otolaryngol Head Neck Surg 1994;120:301–710.1001/archotol.1994.01880270047009CrossRefGoogle ScholarPubMed
5 Belafsky, PC, Potsma, GN, Koufman, JA. Replacement of a failed tracheoesophageal puncture prosthesis under direct vision. Ear Nose Throat J 2001;80:86210.1177/014556130108001207CrossRefGoogle ScholarPubMed
6 Bach, KK, Postma, GN, Koufman, JA. In-office tracheoesophageal puncture using transnasal esophagoscopy. Laryngoscope 2003;113:173–610.1097/00005537-200301000-00032CrossRefGoogle ScholarPubMed
7 Singer, MI, Blom, ED, Hamaker, RC. Voice rehabilitation after total laryngectomy. J Otolaryngol 1983;12:329–34Google ScholarPubMed
8 Eliachar, I, Wood, BG, Lavertu, P, Tucker, HM. Improved endoscopic technique for establishment of tracheo-esophageal puncture. Otolaryngol Head Neck Surg 1994;110:242–5Google ScholarPubMed
9 Barkin, JS, Hartford, JD, Mikalov, A, Flescher, LM. Creation of tracheo-esophageal fistula for voice restoration using the flexible fiberoptic endoscope. Gastrointest Endosc 1991;37:469–7010.1016/S0016-5107(91)70782-7CrossRefGoogle ScholarPubMed
10 Hong, GS, John, AB, Theobald, D, Soo, KC. Flexible endoscopic tracheo-oesophageal puncture under local anaesthetic. J Laryngol Otol 1995;109:1077–910.1017/S0022215100132062CrossRefGoogle ScholarPubMed
11 Singh, V, Brockbank, MJ, Flower, N, Frost, RA. Tracheoesophageal puncture using a flexible gastroscope and a percutaneous endoscopic gastrostomy set. J Laryngol Otol 1997;111:447–810.1017/S0022215100137600CrossRefGoogle Scholar
12 Koch, WM. A failsafe technique for endoscopic tracheoesophageal puncture. Laryngoscope 2001;111:1663–510.1097/00005537-200109000-00032CrossRefGoogle ScholarPubMed
13 Desyatnikova, S, Caro, JJ, Andersen, PE, Cohen, JI, Wax, MK. Tracheoesophageal puncture in the office setting with local anesthesia. Ann Otol Rhinol Laryngol 2001;110:613–1610.1177/000348940111000704CrossRefGoogle ScholarPubMed
14 Eerenstein, SEJ, Schouwenburg, PF. Secondary tracheoesophageal puncture with local anesthesia. Laryngoscope 2002;112:634–710.1097/00005537-200204000-00008CrossRefGoogle ScholarPubMed