In‐Office Tracheoesophageal Puncture Using Transnasal Esophagoscopy

Bach, Kevin K.; Postma, Gregory N.; Koufman, James A.

doi:10.1097/00005537-200301000-00032

Cited by 50 publications

(39 citation statements)

References 19 publications

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“…Reviewing previous studies on the application of unsedated transnasal esophagoscopy or EGD in otolaryngology; however, most investigations have focused on benign diseases, such as globus pharyngius, reflux esophagitis, esophageal foreign body, or placement of the tracheoesophageal puncture. [5][6][7]9,10 Only a limited number of studies have limited experience about the role of unsedated transnasal esophagoscopy or EGD in head and neck oncology. 6,9,11,12 In this article, we provide a detailed report on the efficacy and safety of unsedated transnasal EGD in the diagnosis of hypopharyngeal cancer and screening of simultaneous esophageal lesions.…”

mentioning

confidence: 99%

Application of unsedated transnasal esophagogastroduodenoscopy in the diagnosis of hypopharyngeal cancer

et al. 2008

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mentioning

confidence: 99%

Application of unsedated transnasal esophagogastroduodenoscopy in the diagnosis of hypopharyngeal cancer

et al. 2008

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“…Because of the closed nature of stapler-assisted laryngectomy, however, creation of the TEP was done without direct visualization. As early as 1991, flexible esophagoscopy was used to visualize the esophageal lumen during the creation of the TEP [4][5][6][7][8] . Previous descriptions of TEP utilize the rigid esophagoscope; however, this instrument cannot be used in all patients for a variety of reasons.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to better visualization, the esophagus can be insufflated during the procedure, protecting the posterior esophageal wall from inadvertent injury. The combination of flexible esophagoscope and TEP has been carried out safely as an outpatient procedure for years [4][5][6][7][8] . It has proven to be safe enough for secondary TEP to be performed in the clinic with a transnasal esophagoscope [4,7,9] .…”

Section: Discussionmentioning

confidence: 99%

“…The combination of flexible esophagoscope and TEP has been carried out safely as an outpatient procedure for years [4][5][6][7][8] . It has proven to be safe enough for secondary TEP to be performed in the clinic with a transnasal esophagoscope [4,7,9] . However, this is the first report on combining stapler-assisted laryngectomy and TEP placement using a flexible esophagoscope and a modified Seldinger technique.…”

Section: Discussionmentioning

confidence: 99%

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Primary Tracheoesophageal Puncture in Stapler-Assisted Total Laryngectomy

Leahy¹,

Tufano

2010

ORL

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Background/Aims: The purpose of this article was to present a novel technique for primary tracheoesophageal puncture (TEP) in patients undergoing stapler-assisted laryngectomy. Methods: A case series of 10 consecutive patients treated with stapler-assisted laryngectomy that underwent primary TEP at the time of the initial surgery was conducted. The technique involves the use of a flexible esophagoscope and a modified Seldinger technique to safely create the TEP under direct visualization without disrupting the stapler closure. This series was performed at a single academic institution. The primary outcome measured was ability of alaryngeal speech. Results: A total of 10 consecutive patients had the procedure done. All patients achieved alaryngeal speech and there were no complications. Conclusion: This method allows for a safe and efficient TEP creation at the time of stapler-assisted laryngectomy, obviating the need for secondary procedures, either in the office or operating room.

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“…Currently, the ability to use a lung-powered voice via a tracheoesophageal prosthesis (TEP) offers the best option for rehabilitating speech after a laryngectomy [2]. Creation of the tracheoesophageal fistula, with or without prosthesis placement, can occur at the time of laryngectomy (a primary procedure) or at a subsequent date (a secondary procedure).…”

Section: Introductionmentioning

confidence: 99%

A Novel Device for Placement of a Secondary Tracheoesophageal Voice Prosthesis: A Preliminary Feasibility Study

Tkaczuk¹,

Taylor²,

Wolf³

2018

ORL

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Background: Tracheoesophageal puncture (TEP) for post-laryngectomy speech rehabilitation can be performed at the time of laryngectomy (primary) or at a subsequent time (secondary). Traditionally, the secondary procedure is performed using a rigid esophagoscope. Diseases like esophageal stricture, limited neck extension, and soft-tissue fibrosis can make this procedure technically challenging or impossible. We developed a novel device to perform a secondary tracheoesophageal puncture using a flexible esophagoscope. Objective: To test the feasibility of a novel device used to create a secondary TEP in post-laryngectomy cadavers. Methods: In this study, we performed a total laryngectomy on 3 fresh cadavers to establish the feasibility of our prototype. In each cadaver, a flexible esophagoscope was passed into the pharynx with the prototype. The prototype was passed through a working port and deployed to distend the esophagus. The puncture was visualized and a wire was passed via the newly established fistula. The device was activated, securing the wire, and then the esophagoscope and device were removed. Results: There was 100% successful deployment of the prototype device, allowing rapid creation of the puncture and security of the guide wire in each cadaver. There was no evidence of collateral mucosal injury or esophageal perforation. Conclusions: The prototype device offers an alternative method to safely and efficiently perform a secondary TEP without the requirement of rigid esophagoscopy which can sometimes be technically impossible in this patient population.

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In‐Office Tracheoesophageal Puncture Using Transnasal Esophagoscopy

Cited by 50 publications

References 19 publications

Application of unsedated transnasal esophagogastroduodenoscopy in the diagnosis of hypopharyngeal cancer

Application of unsedated transnasal esophagogastroduodenoscopy in the diagnosis of hypopharyngeal cancer

Primary Tracheoesophageal Puncture in Stapler-Assisted Total Laryngectomy

A Novel Device for Placement of a Secondary Tracheoesophageal Voice Prosthesis: A Preliminary Feasibility Study

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