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Secondary tracheoesophageal puncture with a flexible transillumination device: a new technique and its outcomes

Abstract

Objectives:

This study aims to describe a new secondary tracheoesophageal puncture technique with voice prosthesis insertion under local anesthesia with a low-cost device and evaluate its outcome.

Methods:

With a transoral flexible transillumination device of aluminum of 2.3 mm with fiberoptic light, the esophagus’s anterior wall is visualized through the tracheostomy. A tracheoesophageal fistula is made with a blade and passed through the fistula. Then a bent trocar is introduced into the lumen using the device as a guidewire. Once in the lumen, a thin guide wire is passed through up to the mouth. The voice prosthesis is positioned with retrograde insertion. Then, the patient is discharged without hospitalization.

Results:

15 patients submitted to this technique had a successful surgical outcome. There were no complications as pneumothorax, esophageal perforation, bleeding, or hospitalization.

Conclusion:

The new device is feasible under local anesthesia.

KEYWORDS
Voice prosthesis; Larynx cancer; Laryngectomy; Artificial larynx; Head and neck neoplasms

HIGHLIGHTS

Secondary TEP under local anesthesia generates fewer costs.

Using flexible transillumination device reduces the risk of complications.

Success rates of VP encourage its adoption in laryngectomee patients.

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br