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

Tracheoesophageal Voice Restoration After Salvage Total Laryngectomy

2009 ◽  
Vol 19 (2) ◽  
pp. 58-65 ◽  
Author(s):  
Donna J. Graville ◽  
Andrew D. Palmer ◽  
Mark K. Wax ◽  
Peter E. Andersen
Keyword(s):  
Functional Outcomes ◽  
Total Laryngectomy ◽  
Previous Treatment ◽  
Primary Treatment ◽  
Positive Outcomes ◽  
Recurrent Cancer ◽  
Voice Restoration ◽  
Tracheoesophageal Puncture ◽  
Dramatic Shift ◽  
Reconstructive Techniques

Abstract Since the 1990s there has been a dramatic shift in the management of advanced laryngeal cancer. Today chemoradiation is often performed as a primary treatment with “salvage” total laryngectomy being performed subsequently if needed. In this article, the authors review the current protocols for the diagnosis of recurrent cancer, the surgical and reconstructive techniques used, and the strategies for management of post-operative complications. There is a paucity of literature about the functional outcomes after this type of procedure. It is known that voice restoration with a tracheoesophageal puncture may be challenging in this population of patients due to the complications associated with their previous treatment. Nonetheless, with appropriate patient selection, careful problem-solving, and persistence, positive outcomes may be achieved.

Further Experience with Voice Restoration after Total Laryngectomy

1981 ◽  
Vol 90 (5) ◽  
pp. 498-502 ◽  
Author(s):  
Mark I. Singer ◽  
Eric D. Blom ◽  
Ronald C. Hamaker
Keyword(s):  
Total Laryngectomy ◽  
Residual Function ◽  
Voice Restoration ◽  
Tracheoesophageal Puncture ◽  
Current Report

The current report describes a 40-month experience with 129 patients undergoing voice restoration by endoscopic tracheoesophageal puncture and use of a removable silicone valve. Successful acquisition of voice was achieved in 88% of patients with minimal complications. Observations of this group of laryngectomy patients suggest that esophageal voice is profoundly affected by the residual function of the pharyngeal constrictor musculature. Selective division of these muscles will enhance voice acquisition in a large number of failed esophageal speakers.

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.

Effect of primary neopharyngeal repair on acoustic characteristics of tracheoesophageal voice after total laryngectomy

2008 ◽  
Vol 123 (4) ◽  
pp. 426-433 ◽  
Author(s):  
O A Albirmawy ◽  
A S El-Guindy ◽  
M N Elsheikh ◽  
M E Saafan ◽  
M E Darwish
Keyword(s):  
Total Laryngectomy ◽  
Speaking Rate ◽  
Voice Rehabilitation ◽  
Muscle Repair ◽  
Mean Values ◽  
Voice Restoration ◽  
Pharyngeal Plexus ◽  
Significant Difference ◽  
Tracheoesophageal Puncture ◽  
Repair Group

AbstractObjectives:The tracheoesophageal puncture technique of voice restoration enables successful voice rehabilitation after total laryngectomy. Because post-operative voice quality can vary significantly, depending on which type of hypopharyngeal repair is chosen, the aim of this study was to evaluate the effect of such repair on tracheoesophageal puncture voice after total laryngectomy.Study design:Prospective, clinical study.Setting:Otolaryngology department, Tanta University, Egypt.Methods:Tracheoesophageal puncture voice was quantitatively and qualitatively evaluated in 40 patients using a Provox 2TM prosthesis after standard total laryngectomy. The patients were divided, according to the type of hypopharyngeal repair, into four groups of 10 cases each, as follows: group one, pharyngoesophageal myotomy; group two, pharyngeal plexus neurectomy; group three, non-muscle vertical repair; and group four, transverse repair. These surgical groups were compared with each other with respect to different voice parameters.Results:Patient profiles were almost equivalent in all surgical groups. The mean values of most of the parameters of quantitative tracheoesophageal puncture voice did not differ significantly, comparing the four surgical groups; however, a slightly significant difference was observed regarding loud intensity in the non-muscle repair group, and soft and loud jitter in the transverse repair group. Mean values for qualitative measures of intelligibility and communicative effectiveness did not show significant difference. However, a slightly significant difference was observed regarding fluency, word correctness, speaking rate and wetness, with higher values for all these parameters except wetness in the myotomy group, and higher values for wetness in the non-muscle repair group.Conclusion:The four hypopharyngeal repair types – primary pharyngoesophageal myotomy, pharyngeal plexus neurectomy, non-muscle vertical repair and transverse hypopharyngeal repair – were almost equivalent in prevention of pharyngoesophageal spasm in total laryngectomy patients who had undergone primary tracheoesophageal puncture for voice restoration.

Limitations of the Blom-Singer Technique for Voice Restoration

1981 ◽  
Vol 90 (5) ◽  
pp. 495-497 ◽  
Author(s):  
J. Oliver Donegan ◽  
Jack L. Gluckman ◽  
Jagdev Singh
Keyword(s):  
Patient Selection ◽  
Total Laryngectomy ◽  
Well Being ◽  
Initial Experience ◽  
Great Care ◽  
Home Setting ◽  
Voice Restoration ◽  
Limited Success ◽  
Major Development ◽  
Tracheoesophageal Puncture

The loss of voice following total laryngectomy is a severe blow to a patient's functional and psychological well-being. Since the first laryngectomy numerous attempts at voice restoration have been attempted with only limited success. The tracheoesophageal puncture with insertion of the Blom-Singer valve is a major development in neoglottic reconstruction. Initial reports on the use of this technique have been very encouraging. Our initial experience has not been entirely satisfactory. The difficulties encountered include: 1) inability to manage the prosthesis in the home setting; 2) anatomical problems; 3) inability to produce fluent speech. While it is our impression that this new technique is the simplest and most effective method of voice restoration, it is not appropriate for all laryngectomees. Great care should be exercised in patient selection, and this may eliminate many of the difficulties encountered.

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.

Voice Rehabilitation after Total Laryngectomy and Tracheoesophageal Puncture Using Nonmuscle Closure

1993 ◽  
Vol 102 (10) ◽  
pp. 792-796 ◽  
Author(s):  
Ross A. Clevens ◽  
Duane O. Hartshorn ◽  
Ramon M. Esclamado ◽  
Jan S. Lewin
Keyword(s):  
Total Laryngectomy ◽  
Voice Rehabilitation ◽  
Rehabilitation Outcomes ◽  
Pharyngoesophageal Segment ◽  
Pharyngeal Plexus ◽  
Neck Recurrence ◽  
Tracheoesophageal Puncture ◽  
Early Primary ◽  
Successful Production

The successful production of voice with a tracheoesophageal puncture (TEP) and voice prosthesis requires a compliant pharyngoesophageal segment. Speech failure is commonly attributed to spasm of the pharyngoesophageal segment. During total laryngectomy (TL), a 3-layer closure is typically performed. This prospective single-arm study examines the safety and efficacy of TL and TEP with nonclosure of the pharyngeal musculature to prevent pharyngoesophageal spasm as an alternative to 3-layer closure with pharyngeal plexus neurectomy and/or pharyngeal constrictor myotomy. Twenty-one consecutive patients were enrolled by a single surgeon. The mean duration of follow-up was 19.5 ± 7.9 months. Surgical complications and voice rehabilitation outcomes were examined. An overall complication rate of 28.5% was observed. Fluency was achieved in 75% of patients within a mean of 4.3 ± 5.1 months. Speech failure was attributable to early primary site and neck recurrence (5%), hypoglossal nerve palsy (5%), hypopharyngeal stricture and recurrence (5%), dementia (5%), and intransigent alcohol abuse (5%). Pharyngeosophageal spasm was not observed in any subjects. We conclude that primary TEP with nonclosure of the pharyngeal muscle during TL is relatively safe. Furthermore, it is preferable over 3-layer closure because it avoids pharyngeosophageal spasm, a factor limiting voice rehabilitation.

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