scholarly journals Insertion of Provox®2 voice prosthesis using the anterograde technique immediately after the secondary tracheoesophageal puncture

2005 ◽  
Vol 119 (12) ◽  
pp. 988-990 ◽  
Author(s):  
Raymond W M Ng ◽  
Paul Lam ◽  
Birgitta Y H Wong
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Total Laryngectomy ◽  
Second Generation ◽  
Voice Prosthesis ◽  
Neck Stiffness ◽  
Neck Extension ◽  
Second Stage ◽  
Tracheoesophageal Puncture ◽  
The Voice

Insertion of a voice prosthesis through the tracheoesophageal puncture (TEP) is one way to restore the voice after total laryngectomy. The second generation Provox® voice prosthesis is presently one of the most popular devices. Although TEP can be done primarily, there are many centres that prefer it to be done at a second stage for various reasons. However, secondary TEP for retrograde replacement of prosthesis can be difficult and general anaesthesia is very often necessary. Moreover, the presence of neck stiffness and fibrosis from the surgery or previous radiotherapy could affect the neck extension for proper positioning of the trocar. Similarly, it is difficult to insert the prosthesis if there is stenosis at the pharyngoesophageal segment. We describe a technique in which creation of secondary TEP and insertion of Provox®2 is done with local anaesthesia under the same setting. The procedure is well tolerated and can be safely performed on an out-patient basis.

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.

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.

Applications of the Voice Prosthesis during Laryngectomy

1989 ◽  
Vol 98 (12) ◽  
pp. 921-925 ◽  
Author(s):  
Mark I. Singer ◽  
Eric D. Blom ◽  
Ronald C. Hamaker ◽  
Glen Y. Yoshida
Keyword(s):  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Alaryngeal Speech ◽  
Recent Introduction ◽  
Speech Rehabilitation ◽  
Tracheoesophageal Puncture ◽  
The Voice

With the recent introduction of the voice prosthesis for alaryngeal speech rehabilitation, its application in the early postlaryngectomy period is gaining acceptance. One hundred twenty-eight patients received a tracheoesophageal puncture and adjunctive pharyngeal constrictor relaxation during laryngectomy. The voice prosthesis was applied as early as 10 days after surgery, and the results of a 9-year experience are presented. Eighty percent of the population achieved a durable voice, and the complications were infrequent. The results support the primary use of tracheoesophageal phonation as a relatively safe and reliable alternative to total laryngectomy alone.

’The holiday plug‘: a temporary solution to the problem of the leaking voice prosthesis

1993 ◽  
Vol 107 (12) ◽  
pp. 1149-1150
Author(s):  
Simon N. Rogers ◽  
Andrew Batch ◽  
David Powell ◽  
Kaye Radford
Keyword(s):  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Short Paper ◽  
Patient Visit ◽  
Temporary Solution ◽  
The Voice

AbstractTracheo-oesophageal prostheses are commonly inserted in patients following total laryngectomy to improve the quality of the voice. Unfortunately the device eventually fails and requires replacement. A valve change, although well tolerated by patients, necessitates an out-patient visit and delay in its replacement can lead to problems of pneumonia or dehydration. In this short paper we describe a simple temporary solution for a leaking valve and recommend its use in patients who are delayed in returning to the unit for example when on holiday.

scholarly journals Customization of the voice prosthesis to prevent leakage from the enlarged tracheoesophageal puncture: Results of a prospective trial

2012 ◽  
Vol 122 (8) ◽  
pp. 1767-1772 ◽  
Author(s):  
Jan S. Lewin ◽  
Katherine A. Hutcheson ◽  
Denise A. Barringer ◽  
Lindsay E. Croegaert ◽  
Asher Lisec ◽  
...  
Keyword(s):  
Prospective Trial ◽  
Voice Prosthesis ◽  
Tracheoesophageal Puncture ◽  
The Voice

Closure of Tracheoesophageal Puncture after Total Laryngectomy

2019 ◽  
Vol 161 (2) ◽  
pp. 368-370
Author(s):  
Giuseppe Riva ◽  
Federico Dagna ◽  
Eugenia Ricci ◽  
Andrea Luigi Cavalot
Keyword(s):  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Effective Technique ◽  
Vocal Function ◽  
Tracheoesophageal Puncture ◽  
Rehabilitation Time

Tracheoesophageal puncture with voice prosthesis placement is used to restore vocal function after total laryngectomy. However, closure of the fistula is sometimes needed. At our department, a simple and effective technique for closure was developed. It does not require interposed tissues or materials. Moreover, our procedure allows for a short rehabilitation time for swallowing and a short hospitalization. We describe advantages, pitfalls, and errors to avoid. This technique should not be performed for patients who are irradiated and those with large fistulas.

Evaluation of voice prosthesis placement at the time of primary tracheoesophageal puncture with total laryngectomy

2009 ◽  
Vol 119 (7) ◽  
pp. 1353-1357 ◽  
Author(s):  
Daniel G. Deschler ◽  
Glenn W. Bunting ◽  
Derrick T. Lin ◽  
Kevin Emerick ◽  
James Rocco
Keyword(s):  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Tracheoesophageal Puncture

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

2016 ◽  
Vol 130 (7) ◽  
pp. 686-690 ◽  
Author(s):  
D M Beswick ◽  
E J Damrose
Keyword(s):  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Cricopharyngeal Myotomy ◽  
Single Institution ◽  
Simple Method ◽  
Single Operator ◽  
Valve Placement ◽  
Tracheoesophageal Puncture ◽  
Mean Time

AbstractObjective: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.

scholarly journals Aspiration of tracheoesophageal prosthesis in a laryngectomized patient

2012 ◽  
Vol 7 ◽  
Author(s):  
Sergio C. Conte ◽  
Elena De Nardi ◽  
Federico Conte ◽  
Stefano Nardini
Keyword(s):  
Total Laryngectomy ◽  
Tracheoesophageal Fistula ◽  
Definitive Diagnosis ◽  
Voice Prosthesis ◽  
Voice Rehabilitation ◽  
Case Presentation ◽  
Safe Management ◽  
Tracheal Stoma ◽  
Laryngectomized Patient ◽  
The Voice

Background: The voice prosthesis inserted into a tracheoesophageal fistula has become the most widely used device for voice rehabilitation in patients with total laryngectomy. Case presentation: We describe a case of tracheoesophageal prosthesis’ (TEP) aspiration in a laryngectomized patient, with permanent tracheal stoma, that appeared during standard cleaning procedure, despite a programme of training for the safe management of patients with voice prosthesis. Conclusions: The definitive diagnosis and treatment were performed by flexible bronchoscopy, that may be considered the procedure of choice in these cases, also on the basis of the literature.

Primary versus Secondary Tracheoesophageal Puncture for Speech Rehabilitation in Total Laryngectomy: Long-Term Results with Indwelling Voice Prosthesis

2005 ◽  
Vol 133 (1) ◽  
pp. 89-93 ◽  
Author(s):  
Carlos T. Chone ◽  
Flávio M. Gripp ◽  
Ana L. Spina ◽  
Agricio N. Crespo
Keyword(s):  
Success Rate ◽  
Total Laryngectomy ◽  
Voice Prosthesis ◽  
Long Term Results ◽  
Voice Rehabilitation ◽  
Patient Age ◽  
Patient Âgé ◽  
Tracheoesophageal Puncture

OBJECTIVE: To evaluate the long-term use of indwelling Blom-Singer voice prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). The influence of the timing (primary or secondary) of tracheoesophageal puncture (TEP), use of radiotherapy (xRT), patient age, and length of follow-up were studied to evaluate the success rate of VP use. STUDY DESIGN AND SETTING: Prospective clinical study in a tertiary referral center. Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. All patients were evaluated for vocal functional issues by an otolaryngologist and a speech pathologist at 1 month, then at every 3 months up to 1 year, and then at every 6 months after 1 year of follow-up. The relative data on time of placement of VP, time of VP use, xRT, age, length of follow-up, and life span of each VP were recorded during the follow-up. RESULTS: Eighty-seven percent of the patients underwent primary and 13%, secondary TEP. The follow-up varied from 12 to 87 months, with an average of 38 months for primary and 51 months for secondary TEP. Fifty-nine percent of the patients were submitted to xRT. The general rate of success was 94%, with 97% for primary and 78% ( P = 0.07) for secondary TEP; after 2 years, the success rate was 96% for primary and 75% for secondary ( P = 0.07) TEP. The use of xRT and patient age had no influence on the success of VP use for primary and secondary TEP, independently of the length of follow-up. CONCLUSIONS: The success rate of voice rehabilitation with VP was 94%. In primary TEP, the success rate was 97%, whereas in secondary TEP it was 78%; 2 years later, it was 96% and 75%, respectively. A tendency for a higher success rate in voice rehabilitation after TL was observed in primary TEP. The use of xRT and age of patient had no influence on the success rate.

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