Alternative management of leaking tracheoesophageal fistula after laryngectomy using nasal septal button

Wong, Billy; Kurian, Marina; Chidambaram, Ambika G.

doi:10.1111/j.1749-4486.2010.02248.x

Cited by 6 publications

(12 citation statements)

References 3 publications

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“…1 ). 9 10 11 13 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 Using the OCEBM, 33 studies had a level of evidence of 4. No discrepancies during quality assessment occurred.…”

Section: Resultsmentioning

confidence: 99%

“…8,43,44 Additionally, tissue may be of uncertain quality if neck dissections have been performed or if the flap was within the radiated field. 31,44,45 Microvascular free tissue transfer has asserted itself as the standard of care in reconstruction of complex head and neck defects due to the advantage of size-specific tailored flaps and to the availability of chimeric tissue with multilayered components. 9 The RFF flap is a thin, pliable fasciocutaneous flap with a large pedicle considered ideal by many authors for TEP closure.…”

Section: Discussionmentioning

confidence: 99%

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Definitive Closure of the Tracheoesophageal Puncture Site after Oncologic Laryngectomy: A Systematic Review and Meta-Analysis

et al. 2022

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Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure.A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed.Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1–13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1–43%), 7% (95% CI < 1–34%) for dermal graft interposition, < 1% (95% CI < 1–37%) for radial forearm free flap, < 1% (95% CI < 1–52%) for ligation of the fistula, 17% (95% CI < 1–64%) for interposition of a deltopectoral flap, 9% (95% CI < 1–28%) for primary closure, and 2% (95% CI < 1–20%) for interposition of a sternocleidomastoid muscle flap.Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Definitive Closure of the Tracheoesophageal Puncture Site after Oncologic Laryngectomy: A Systematic Review and Meta-Analysis

et al. 2022

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“…Septal buttons have shown promising results in plugging a leaking tracheoesophageal fistula. 7,8 For example, Smith and Rockhill reported a veterinary case in which a septal button was successfully used to repair an oronasal fistula in a cat. 9 To the best of our knowledge, no case of the use of a septal button to repair an oronasal communication in a human has been previously reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Management of a cocaine-induced palatal perforation with a nasal septal button

Trimarchi

Sykopetrites²,

Bussi³

2016

Ear Nose Throat J

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A cocaine-induced midline destructive lesion (CIMDL) is a rare consequence of cocaine insufflation that involves the nose, sinuses, and occasionally the palate. Palatal perforations compromise swallowing, mastication, and speech. An obturator prosthesis can be used to overcome these complications. In selected cases, a nasal septal button is a good alternative for the sealing of a palatal perforation, especially when surgery is not indicated, such as in cases of persistent cocaine abuse. Abstinence from cocaine is the most effective long-term management option for patients with a CIMDL, and surgical correction of the defect should be postponed until the patient stops sniffing cocaine and the lesion becomes stable. We describe the case of a 39-yearold cocaine abuser whose oronasal communication was plugged with a nasal septal button, which resulted in an immediate alleviation of his oronasal reflux.

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“…A nasal septal button has been used to manage a tracheoesophageal fistula after a laryngectomy. 4 We describe a novel use of a clear septal button as a temporary measure to control secretions from an OCF after total laryngectomy. The patient was a 55-year-old man with pT4N2cMx stage IV squamous cell cancer of the base of the tongue on the left side.…”

mentioning

confidence: 99%

“…Wong et al evaluated the use of a nasal septal button for preventing aspiration pneumonia from the site of a leaking tracheoesophageal prosthesis. 4 They noted that the use of simple procedures obviates the risks of general anesthesia, especially when patients must undergo an exhaustive procedure. The only complication they anticipated was the development of candidiasis around the prosthesis, which can be treated with antifungals.…”

mentioning

confidence: 99%