A tracheo-esophageal puncture technique for voice restoration after laryngectomy

In‐Office Tracheoesophageal Puncture Using Transnasal Esophagoscopy

“…Initial descriptions of secondary TEP focused on techniques employing rigid esophagoscopes during general anesthesia. 4–7 Although efficacious in the majority of patients, these rigid techniques have several drawbacks. Often, passing the rigid endoscope is difficult, particularly in the irradiated patient, because of limited passive neck extension, cervical spondylosis, cervical osteophytes, stenosis of the neopharynx at the resection site, prominent superior incisors, or a low stoma in a long neck.…”

Secondary tracheoesophageal puncture: Blind technique with a rigid hysterometer

“…Alternative methods of TEP and voice prosthesis housing need to be used in patients with anatomy that does not allow proper passage of large‐caliber rigid instruments. These variations include the use of rigid and flexible endoscopes, a potassium titanyl phosphate laser passed transorally via a suction tube, endotracheal tubes, percutaneous gastrostomy sets, etc 13–21…”

An Alternative Approach for Secondary Tracheoesophageal Puncture in the Difficult Laryngectomy Neck

“…Although use of a rigid esophagoscope for placement of the prosthesis is the most widely used technique, variations to the procedure have been reported. These variations include the KTP laser, both rigid and flexible endoscopes, percutaneous gastrostomy sets, as well as a variety of introducer kits and clamps 2–5 . Although the secondary TEP is a relatively simple procedure, there have been many reported complications, including esophageal injury, mediastinitis, creation of a false passage, and cervical spine fracture 6 .…”

“…These variations include the KTP laser, both rigid and flexible endoscopes, percutaneous gastrostomy sets, as well as a variety of introducer kits and clamps. [2][3][4][5] Although the secondary TEP is a relatively simple procedure, there have been many reported complications, including esophageal injury, mediastinitis, creation of a false passage, and cervical spine fracture. 6 Although these complications may be rare, they are very real and tend to occur at a greater frequency in patients with difficult anatomy.…”