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ORIGINAL ARTICLE
Otorinolaringologia 2018 March;68(1):28-32
DOI: 10.23736/S0392-6621.17.02135-X
Copyright © 2017 EDIZIONI MINERVA MEDICA
language: English
Primary versus secondary tracheoesophageal puncture: how similar are they?
Ignazio LA MANTIA 1, Gianluca ALBANESE 1, Claudio ANDALORO 2 ✉
1 Department of Medical Sciences, Surgical and Advanced Technologies, University of Catania, Catania, Italy; 2 Unit of Ear Nose and Throat, Santa Marta e Santa Venera Hospital, Acireale, Catania, Italy
BACKGROUND: Tracheoesophageal puncture (TEP) and placement of voice prosthesis (VP) have become the method of choice to achieve speech rehabilitation after total laryngectomy. A retrospective clinical analysis has been conducted to compare the complications and success in speech rehabilitation of patients undergoing rehabilitation after primary and secondary TEP.
METHODS: Clinical records of 110 patients underwent laryngectomy with the placement of a VP between July 2010 and July 2017 were retrospectively reviewed. Demographics, disease variables, and surgical factors were reviewed. Speech outcome, VP lifetime and TEP complication rates were compared between patients in whom TEP was performed as a primary or a secondary procedure.
RESULTS: TEP was performed as a primary procedure in 60 patients and a secondary procedure in 50. Patients demographics were similar between groups (P>0.05), apart from the age, who perform secondary TEP were older than those with primary TEP (107.13±8.25 vs. 97.54±6.16; P=0.046). No significant differences in device lifetime (P=0.327), surgical complications (P=0.301), prosthesis-related complications (P=0.448), and success scores (P=0.097), were observed between patients with primary and secondary TEP.
CONCLUSIONS: Our findings suggest that primary and secondary TEP are equally safe and effective procedures. We recommend that primary TEP should be preferred because of avoiding a second surgical intervention and allowing early voice restoration following laryngectomy.
KEY WORDS: Laryngectomy - Tracheoesophageal fistula - Punctures - Prostheses and implants