A simple technique for closure of persistent tracheoesophageal fistula after total laryngectomy

2009 ◽  
Vol 140 (4) ◽  
pp. 601-603 ◽  
Author(s):  
Sandra Schmitz ◽  
Jean-Philippe Van Damme ◽  
Marc Hamoir
Keyword(s):  
Total Laryngectomy ◽  
Tracheoesophageal Fistula ◽  
Simple Technique

Surgical Closure of Tracheoesophageal Puncture Without a Flap Interposition

2020 ◽  
Vol 163 (3) ◽  
pp. 618-620
Author(s):  
João Fonseca Neves ◽  
Ana Rita Nobre ◽  
Edite Portugal ◽  
Francisco Branquinho
Keyword(s):  
Surgical Technique ◽  
Total Laryngectomy ◽  
Tracheoesophageal Fistula ◽  
Skin Flap ◽  
Anterior Segment ◽  
Continuous Suture ◽  
Vocal Rehabilitation ◽  
Surgical Closure ◽  
Tracheoesophageal Puncture ◽  
Suture Closure

Tracheoesophageal puncture for voice prosthesis placement is often used in vocal rehabilitation of patients undergoing total laryngectomy. Although its closure can occur spontaneously, some patients require a surgical procedure. We propose a surgical technique, without flap interposition, that begins with careful separation of the esophagus and trachea and identification of the site of tracheoesophageal fistula. After continuous suture closure of the esophagus, the anterior segment of the first tracheal rings is vertically incised to facilitate tracheal closure in a suture without tension. Finally, a small pectoral skin flap is made and mobilized to suture to the free edges of the sectioned tracheal rings, thus reducing the risk of tracheal stenosis. Four patients underwent this procedure with uneventful postoperative evolution and permanent closure of the fistula.

scholarly journals Tracheoesophageal puncture site closure with sternocleidomastoid musculocutaneous transposition flap

2015 ◽  
Vol 48 (03) ◽  
pp. 278-282 ◽  
Author(s):  
Dushyant Jaiswal ◽  
Prabha Yadav ◽  
Vinay Kant Shankhdhar ◽  
Rajendra Suresh Gujjalanavar ◽  
Prashant Puranik
Keyword(s):  
Total Laryngectomy ◽  
Tracheoesophageal Fistula ◽  
Leading Edge ◽  
Puncture Site ◽  
Transposition Flap ◽  
Oesophageal Mucosa ◽  
Surgical Methods ◽  
Post Radiation ◽  
Tracheoesophageal Puncture ◽  
Second Procedure

ABSTRACT Introduction: Tracheoesophageal voice prosthesis is highly effective in providing speech after total laryngectomy. Although it is a safe method, in certain cases dilatation or leakage occurs around the prosthesis that needs closure of tracheoesophageal fistula. Both non-surgical and surgical methods for closure have been described. Surgical methods are used when non-surgical methods fail. We present the use of the sternocleidomastoid musculocutaneous (SCMMC) transposition flap for the closure of tracheoesophageal fistula. Materials and Methods: An incision is made at the mucocutaneous junction circumferentially around the tracheostoma. Tracheoesophageal space is dissected down to and beyond the fistula. The tracheoesophageal tract is divided. The oesophageal mucosa is closed with simple sutures. Then SCMMC transposition flap is raised and transposed to cover sutured oesophagus and the defect between the oesophagus and the trachea. Results: This study was done prospectively over a period of 1 year from June 2012 to May 2013. This technique was used in patients with pliable neck skin. In nine patients, this procedure was done (inferior based flap in nine cases) and it was successful in eight patients. In one case, there was dehiscence at the leading edge of flap with oesophageal dehiscence, which required a second procedure. In two cases, there was marginal necrosis of flap, which healed without any intervention. Nine patients in this series were post-radiation. Conclusion: This method of closure is simple and effective for patients with pliable neck skin, who require permanent closure of the tracheoesophageal fistula.

A simple technique to prevent stenosis of the tracheostoma after total laryngectomy

1980 ◽  
Vol 94 (6) ◽  
pp. 637-642 ◽  
Author(s):  
Nobuhiko Isshiki ◽  
Masahiro Tanabe
Keyword(s):  
Total Laryngectomy ◽  
Simple Technique

AbstractStenosis of the tracheostoma after total laryngectomy can be prevented by the addition of a simple Y-incision to the U-incision for total laryngectomy. This technique ensures a wide stoma, eliminating the need of tracheal cannulation even immediately after surgery

scholarly journals Videostroboscopic Evaluation of Neoglottis in Alaryngeal Patients after Tracheoesophageal Voice Reconstruction without Prosthesis

2009 ◽  
Vol 24 (2) ◽  
pp. 14-18
Author(s):  
Jeanne O. Madrid ◽  
Celso V. Ureta
Keyword(s):  
Total Laryngectomy ◽  
Tracheoesophageal Fistula ◽  
Public Hospital ◽  
Sound Production ◽  
Myocutaneous Flap ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Voice Production ◽  
Alaryngeal Speech

Objective:  To investigate by means of videostoboscopy the characteristics of the neoglottis after total laryngectomy with primary or secondary voice reconstruction using a non-prosthetic tracheoesophageal fistula technique Methods:        Design: Cross-Sectional Study Setting: Tertiary Public Hospital        Subjects: Twenty alaryngeal patients Results:  Videostroboscopy enabled evaluation of the neoglottis in all but two patients with a pectoralis major myocutaneous flap reconstruction of the pharyngoesophageal segment. Pooling of saliva was present in the cranial neoglottic opening in all subjects, but obscured visualization in these two. A circular neoglottic shape was most commonly seen.  Vibration of the neoglottis was noted in 90% of all alaryngeal patients and was associated with a regular mucosal wave.  Pharyngoesophageal vibration was noted in two thirds of patients.  It was associated with a strong mucosal wave, regular vibration and a longer open phase. Conclusion: Videostroboscopy confirmed that neoglottic vibration accompanies sound production while pharyngoesophageal vibration may reinforce and enhance voice production in alaryngeal patients with non-prosthetic TE voice reconstruction.    Keywords:  larynx, total laryngectomy, voice reconstruction, tracheoesophageal (te) fistula speech, alaryngeal voice, alaryngeal speech, videostrobe    

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