Silastic Surgical Stent and Dilator for use with the Singer-Blom Voice Restoration Procedure

1982 ◽  
Vol 90 (2) ◽  
pp. 223-225 ◽  
Author(s):  
Robert H. Ossoff ◽  
David R. Barnes ◽  
Michael E. Goldman ◽  
George A. Sisson
Keyword(s):  
Tracheoesophageal Fistula ◽  
Voice Prosthesis ◽  
Puncture Site ◽  
Voice Restoration ◽  
Polyester Suture ◽  
Tracheoesophageal Puncture ◽  
Puncture Technique

A Silastic surgical stent with an indwelling No. 2 Dacron polyester suture and a Silastic dilator have been designed for use in conjunction with Singer and Blom's tracheoesophageal puncture technique for voice restoration. The surgical stent is used to form the tracheoesophageal fistula; the Silastic dilator is sent home with each patient to be used as an atraumatic dilator if the puncture site becomes too small to allow for the insertion of the Singer-Blom voice prosthesis.

Tracheoesophageal Puncture for Voice Restoration: Modification of the Blom-Singer Technique

1984 ◽  
Vol 92 (4) ◽  
pp. 418-423 ◽  
Author(s):  
Robert H. Ossoff ◽  
Cathy L. Lazarus ◽  
George A. Sisson
Keyword(s):  
Postoperative Period ◽  
Modified Technique ◽  
Puncture Site ◽  
Voice Restoration ◽  
Polyester Suture ◽  
Tracheoesophageal Puncture

We have used a modification of the Blom-Singer technique in our last 24 tracheoesophageal punctures, performed on 20 patients. At the time of puncture a surgical stent with an indwelling Dacron polyester suture is placed to form the fistula. Forty-eight to 72 hours later the stent is backed out of the puncture site but the suture is allowed to remain. The Blom-Singer duckbill prosthesis is fitted and taped in the routine fashion. The suture is left to traverse the tracheoesophageal tract until the time of discharge, when it is removed. At discharge the patient is given a Silastic dilator, to be used if the puncture site becomes too small to allow for insertion of the duckbill prosthesis. Seventeen of the 20 patients in this group obtained good voice. Six operations would have been failures because of the loss of the patient's prosthesis in the immediate postoperative period if the modified technique had not been used.

scholarly journals Aspirated Voice Prosthesis: A Unique Complication of Post Total Laryngectomy Voice Rehabilitation

2012 ◽  
Vol 2 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Sudhir M Naik
Keyword(s):  
Case Report ◽  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Voice Rehabilitation ◽  
Wide Field ◽  
Wide Angle ◽  
Puncture Site ◽  
History Of ◽  
Tracheoesophageal Puncture ◽  
The Voice

ABSTRACT Background/objectives Prosthetic voice rehabilitation after total laryngectomy has proven to be successful in restoring proper speech function in over 90% of patients. The possibility of achieving effective speech using the voice prosthesis is superior to esophageal speech and electrolarynx. Setting Department of Head and Neck Oncosurgery, Kidwai Memorial Institute of Oncology, Bengaluru. Case report A 75-year-old female who had undergone wide field laryngectomy 14 months back came with history of lost voice prosthesis which was later found aspirated. It was removed by the bronchoscopic forceps under topical anesthesia by visualizing it by a nasal 0° wide angle endoscope. The puncture site was cleaned and allowed to cicatrize and narrow down. The fistula was closed by topical application of silver nitrate. Conclusion Tracheoesophageal puncture and prosthesis rehabilitation has emerged as the standard voice rehabilitation of laryngectomized patients. Patient education regarding maintenance of the prosthesis and the care for the tracheostoma is important in reducing the complications. How to cite this article Naik SM. Aspirated Voice Prosthesis: A Unique Complication of Post Total Laryngectomy Voice Rehabilitation. Int J Phonosurg Laryngol 2012;2(1):41-45.

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.

scholarly journals Tracheoesophageal puncture technique (singer-blom) for voice restoration after total laryngectomy.

1985 ◽  
Vol 36 (6) ◽  
pp. 481-487 ◽  
Author(s):  
Minoru Kinishi ◽  
Kunihiko Makino ◽  
Mitsutake Tani ◽  
Mutsuo Amatsu
Keyword(s):  
Total Laryngectomy ◽  
Voice Restoration ◽  
Tracheoesophageal Puncture ◽  
Puncture Technique

Voice Restoration following Laryngectomy: The Role of Primary versus Secondary Tracheoesophageal Puncture

1989 ◽  
Vol 98 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Barry L. Wenig ◽  
Joan Levy ◽  
Virginia Mullooly ◽  
Allan L. Abramson
Keyword(s):  
Voice Prosthesis ◽  
Voice Production ◽  
Voice Restoration ◽  
Data Support ◽  
Tracheoesophageal Puncture

A protocol was established at our institution to compare a series of primary and secondary tracheoesophageal punctures using the Singer-Blom voice prosthesis. Over a 24-month period, 20 primary and 18 secondary punctures were performed. Voice production, fluency of voice, and functional use were graded. Our data support the use of both primary and secondary voice restoration following laryngectomy.

Autologous platelet-rich fibrin: a novel method for tracheoesophageal puncture site closure: a case report

2021 ◽  
Vol 30 (3) ◽  
pp. 234-237
Author(s):  
Valentina Pinto ◽  
Paolo G Morselli ◽  
Vittorio Sciarretta ◽  
Ottavio Piccin
Keyword(s):  
Tracheoesophageal Fistula ◽  
Local Treatment ◽  
Local Application ◽  
Fistula Closure ◽  
Puncture Site ◽  
Platelet Rich Fibrin ◽  
Novel Method ◽  
Tracheoesophageal Puncture ◽  
Autologous Platelet

Closure of a tracheoesophageal puncture site performed during voice prosthesis implantation may sometimes be required. Besides local techniques, more elaborate procedures, such as closure by means of free microvascular flaps, have been advocated. In this report, we describe a case of local treatment of a hard-to-heal fistula with local application of autologous platelet-rich fibrin matrix in a 77-year-old male patient. At one-week follow-up, the size of the fistula had decreased dramatically but some leakage remained when drinking. After one month, the patient was able to drink and eat normally without any leakage. There was no recurrence of the leakage at two years' follow-up. In summary, local application of platelet-rich fibrin seems to be a simple, safe and effective procedure for tracheoesophageal fistula closure.

Prevention of aspiration following recurrent dislodgement of voice prosthesis: a patient's innovation

2008 ◽  
Vol 123 (6) ◽  
pp. 680-682
Author(s):  
M Masaany ◽  
M B Marina ◽  
A Asma ◽  
A Sani
Keyword(s):  
Total Laryngectomy ◽  
World Literature ◽  
Tracheoesophageal Fistula ◽  
Voice Prosthesis ◽  
Voice Restoration ◽  
The World ◽  
Carcinoma Of The Larynx ◽  
Cheap Method ◽  
Tracheal Stoma ◽  
The Voice

AbstractObjective:To demonstrate a simple, practical, cheap method of preventing potentially fatal aspiration of a dislodged voice prosthesis; this method was developed by a laryngectomised patient.Case report:A patient diagnosed with squamous cell carcinoma of the larynx underwent total laryngectomy. Upon completion of radiotherapy, a tracheoesophageal fistula was created and a voice prosthesis inserted to enable voice restoration. Unfortunately, the patient presented subsequently with repeated episodes of dislodgement and an episode of potentially fatal aspiration of the voice prosthesis, despite various measures taken by the surgeons to overcome the problem. The patient subsequently developed a method enabling him to retrieve the voice prosthesis himself should it become dislodged. He attached a ring to the prosthesis, which was larger in diameter than the tracheal stoma, thus preventing ingestion or recurrence of aspiration.Conclusion:To our knowledge, this is the first report in the world literature of this form of innovation, created by a laryngectomised patient, to overcome the problem of aspiration or ingestion of a dislodged voice prosthesis.

Transnasal oesophagoscopy-guided in-office secondary tracheoesophageal puncture

2007 ◽  
Vol 122 (3) ◽  
pp. 303-306 ◽  
Author(s):  
V S Doctor ◽  
D J Enepekides ◽  
D G Farwell ◽  
P C Belafsky
Keyword(s):  
Local Anaesthetic ◽  
Total Laryngectomy ◽  
Reliable Method ◽  
Voice Rehabilitation ◽  
Intravenous Sedation ◽  
Puncture Site ◽  
Endoscopic Techniques ◽  
Voice Restoration ◽  
Tracheoesophageal Puncture ◽  
Rigid Oesophagoscopy

AbstractObjective: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.

Periprosthetic Leakage in Tracheoesophageal Prosthesis: Proposal of a Standardized Therapeutic Algorithm

2021 ◽  
pp. 019459982098334
Author(s):  
Claudio Parrilla ◽  
Ylenia Longobardi ◽  
Jacopo Galli ◽  
Mario Rigante ◽  
Gaetano Paludetti ◽  
...  
Keyword(s):  
Total Laryngectomy ◽  
Retrospective Cohort ◽  
Voice Prosthesis ◽  
Management Algorithm ◽  
Therapeutic Algorithm ◽  
Periprosthetic Leakage ◽  
Tracheoesophageal Puncture ◽  
The University ◽  
The Voice

Objective Periprosthetic leakage represents the most demanding long-term complication in the voice prosthesis rehabilitation. The aim of this article is to discuss the various causes of periprosthetic leakage and to propose a systematic management algorithm. Study Design Retrospective cohort study. Setting Otolaryngology clinic of the University Polyclinic A. Gemelli–IRCCS Foundation. Methods The study included 115 patients with voice prosthesis who were treated from December 2014 to December 2019. All patients who experienced periprosthetic leakage were treated with the same step-by-step therapeutic approach until it was successful. Incidence, management, and success rate of every attempt are analyzed and discussed. Results Periprosthetic leakage was reported 330 times by 82 patients in 1374 clinic accesses. Radiotherapy, timing of tracheoesophageal puncture, and type of total laryngectomy (primary or salvage) did not influence the incidence of periprosthetic leakage. Salvage total laryngectomy increases the risk of more clinically relevant leakages. Conclusion By using a systematic algorithm with a step-by-step standardized approach, periprosthetic leakage management could become a less treacherous issue.

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