Deep Neck Abscess after Tracheoesophageal Puncture and Insertion of a Voice Button Prosthesis

Ruth, Harry; Davis, William E.; Renner, Gregory J.

doi:10.1177/019459988509300622

Cited by 37 publications

(19 citation statements)

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“…Komplikationen mit gravierenden medizinischen Folgen, wie retropharyngealer Abszeß mit Carotisarrosion, Halswirbelsäulenosteomyelitis, Pneumothorax,Pneumomediastinum oder gar ein Todesfall,die von manchen Autoren [2,12,17,21,30] in den 80er Jahren beschrieben wurden,traten bei unseren Patienten nicht auf.Ein Pneumothorax als Folge eines hohen Anblasedruckes bei vorgeschädigter Lunge (Emphysenbronchitis) ist auch heute durchaus vorstellbar, die pulmonale Situation des Patienten sollte daher bei der Indikationsstellung zur Stimmprothese einbezogen werden.Im eigenen Patientengut machte ein fortschreitendes Asthma bronchiale bei einem Patienten den Gebrauch der Stimmprothese unmöglich und daher ihre Entfernung notwendig. Weitere -weniger gravierende -Komplikationen, die in der Literatur beschrieben werden, wie Dysphagie, persistierender Spasmus des Constrictor pharyngis, zu tiefe / zu hohe Anlage der Fistel,cervikales Luftemphysem, Hypopharynx-, Tracheostomastenose [2,9,10,29] fanden sich bei unseren Patienten nicht.…”

Section: Diskussionunclassified

Management von Komplikationen nach prothetischer Stimmrehabilitation

Neumann

Hj²

2000

HNO

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The growing popularity of prosthetic voice restoration after total laryngectomy confronts ENT specialists with an increasing number of prosthesis-related complications. The ENT specialist should be familiar with the management of these complications in order to maintain the patients speech and social rehabilitation. In a retrospective study on 108 consecutive patients, complications were encountered in 30%. The incidence was not related to the factors age or primary vs. secondary insertion of the prosthesis. Complications consisted of formation of granulation tissue (15.7%), shunt dilatation (5.5%), loss of prosthesis (3.7%), local cellulitis (2.8%), extrusion (1.9%), ingrowth of prosthesis (1.9%) and formation of excessive scar tissue with dislocation of prosthesis (0.9%). Permanent removal of the prosthesis due to complications was necessary in 3 cases (2.8%). Therapeutic measures for the management of complications are described and evaluated. The treatment of complications was well tolerated by all patients and led to satisfying results in most cases. Our observations show that prosthetic voice rehabilitation is associated with various difficulties and complications, but that these can be handled quite easily and successfully in the majority of cases.

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Section: Diskussionunclassified

Management von Komplikationen nach prothetischer Stimmrehabilitation

Neumann

Hj²

2000

HNO

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“…Protez içinden veya etrafından akıntı, mantar kolonizasyonu, granülasyon dokusu oluşumu, protezin yer değiştirmesi gibi komplikasyonlar yanında bronşiyal aspirasyon, mediastinit, sepsis, özofageal aspirasyon, derin boyun enfeksiyonu, aspirasyon pnömonisi gibi yaşamı tehdit edici komplikasyonlarla da karşılaşılabilmektedir. [6][7][8][9][10][11][12][13][14][15][16] Trakeoözofageal fistül ister primer ister sekonder olarak açılsın en sık ses protezi komplikasyonu protez içinden veya etrafından akıntıdır. Literatürde protez içinden veya etrafından sızıntı komplikasyonu sıklığı %13-82.5 arasında değişen oranlarda bildirilirken [6][7][8][9] bizim çalışmamızda %43 oranında görüldü.…”

Section: Discussionunclassified

Complications of voice prosthesis application after total laryngectomy

Koç¹

2014

Praxis of ORL

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Amaç: Bu çalışmada ses protezi uygulaması sırasında ve sonrasında karşılaşılan komplikasyonlar sunuldu. Hastalar veYöntemler: Ocak 2005 -Aralık 2011 tarihleri arasında Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Kulak Burun Boğaz Kliniği'nde larenks skuamöz hücreli karsinom nedeniyle total larenjektomi yapılan ve sekonder trakeoözofageal fistülle birlikte ses protezi (42'si provox 1, 296'sı provox 2 olmak üzere toplam 338 ses protezi) uygulanan toplam 42 hastada (40 erkek, 2 kadın; ort. yaş 59.4±9.4 yıl; dağılım 56-70 yıl) karşılaşılan komplikasyonlar retrospektif olarak incelendi. Bulgular: Kırk iki hastanın 26'sında (%61.9) toplam 55 (%16.3) komplikasyonla karşılaşıldı. On sekiz kez (%5.3)protez içinden veya etrafında akıntı, 14 kez (%4.1) granülasyon dokusu oluşumu, altı kez (%1.8) protezin fistül içine gömülmesi sonucu yer değiştirmesi, altı kez (%1.8) trakestomal darlık, beş kez (%1.5) fistül genişlemesi, iki kez (%0.6) mantar kolonizasyonu, bir kez (%0.3) mukozal apseleşme, bir kez (%0.3) boyunda ve yüzde cilt altı amfizem gelişimi, bir kez (%0.3) özofageal aspirasyon ve bir kez (%0.3) trakeobronşiyal aspirasyon görüldü. Protez işleminin komplikasyon oranı %16.3 olarak hesaplandı. Kırk iki hastanın 36'sında (%85.7) etkin konuşma sağlandı. Sonuç: Ses protezi uygulamasında çeşitli komplikasyonlarla karşılaşılmaktadır. Bu komplikasyonların bir kısmı yaşamı tehdit edici olmaktadır. Komplikasyonları azaltmada ses protezlerinin erken deforme olmasının önlenmesi ile birlikte cerrahi deneyim büyük önem taşımaktadır. Anahtar Sözcükler: Komplikasyon; total larenjektomi; ses protezi; ses rehabilitasyonu.Objectives: This study aims to present complications encountered intra-and post of voice prosthesis practice. Patients and Methods:Between January 2005 and December 2011, we retrospectively evaluated complications of voice prosthesis practice on 42 total laryngectomized and secondary tracheoesophageal punctured patients (40 males, 2 females; mean age 59.4±9.4 years; range 56 to 70 years) who were operated for laryngeal squamous cell carcinoma in Bakırköy Dr. Sadi Konuk Training and Research Hospital, Ear-Nose-Throat Clinic (a total of 338 voice prostheses including 42 provox 1, 296 provox 2). Results:A total of 55 complications (16.3%) were encountered in 26 (61.9%) of 42 patients. These were 18 times (5.3%) leakage around or inside prosthesis, 14 times (4.1%) granulation tissue occurring, six times (1.8%) prosthesis displacement due to its embedded position within the fistula, six times (1.8%) tracheostomal stenosis, five times (1.5%) fistulae enlargement, two times (0.6%) fungal colonization, one times (0.3%) mucosal abscess, one times (0.3%) subcutaneous emphysema on neck and face, one times (0.3%) esophageal aspiration and one times (0.3%) tracheobronchial aspiration. Complication rate on prosthesis placement procedures was calculated as 16.3%. Thirty-six patients (85.7%) of a total of 42 patients achieved effective speech. Conclusion:Various complications are encountered in voice prosthesis practice. Som...

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“…After the Blom-Singer puncture and voice prosthesis implantation, mild but also severe complications may develop in some cases. Andrews et al [1], Ruth et al [7], Silver et al [11], Šebová and Löbe [9], Sisson et al [13] and Senders and Bumsted [10] reported the following complications after Blom-Singer puncture: mediastinitis, irreversible pharyngo-esophageal stenosis, para-esophageal abscess, and osteomyelitis cervicalis. Although these complications occur only in a small percentage of cases, they are of great importance for the individual patient.…”

Section: G Lichtenbergermentioning

confidence: 99%

Advances and refinements in surgical voice rehabilitation after laryngectomy

Lichtenberger¹

2001

European Archives of Oto-Rhino-Laryngology

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After Blom and Singer reported the construction of the so-called "duck bill" prosthesis in 1980, there have been quite a few newer voice prostheses constructed by other workers and new methods developed to predict the results, such as the insufflation and lidocaine test. Implanting the voice prosthesis with the Blom-Singer method has presented some problems and complications related to the puncture technique, therefore the following simplified esophagotracheal puncture technique is presented. The pharynx is opened with the laryngoscope which is then led up to the entrance of the esophagus. Through the laryngoscope, the distal end of the endo-extralaryngeal needle carrier, developed by the author and modified for mass production by R. Wolf Ltd., Germany, is led into the esophagus. The instrument is pushed forward as long as its distal bent, blunt end is palpable in the upper third of the tracheostoma. The needle with the thread (2/0 prolene) is pushed through from the inside, out in the upper third of the tracheostoma. A double wire forming a loop is led through the pointed metal cone (containing a built-in needle) and the catheter and tied behind a counterfixing pierced ball. The 2/0 prolene leading thread is then knotted with the wire. By pulling the thread and the wire, the pointed end of the metal cone with the needle built-in, perforates the soft parts and pulls the catheter with it (the same procedure will be used for primary puncture as well). After this procedure the voice prosthesis can easily be placed in the fistula in a conventional manner. Using this technique, 59 patients could be implanted without puncture-related complications or problems. Problems, not related to the puncture technique, such as Candida albicans infection etc., were solved using the well-known treatment modalities. To stop leakage around the prosthesis, injection of Bioplastique into the soft tissue surrounding the fistula was used with success.

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Deep Neck Abscess after Tracheoesophageal Puncture and Insertion of a Voice Button Prosthesis

Cited by 37 publications

References 0 publications

Management von Komplikationen nach prothetischer Stimmrehabilitation

Management von Komplikationen nach prothetischer Stimmrehabilitation

Complications of voice prosthesis application after total laryngectomy

Advances and refinements in surgical voice rehabilitation after laryngectomy

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