Surgical complications of tracheo-oesophageal puncture and speech valves

Malik, Tass; Bruce, Iain; Cherry, John R

doi:10.1097/moo.0b013e3280964dc8

Cited by 46 publications

(54 citation statements)

References 74 publications

(114 reference statements)

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“…The insertion of a voice prosthesis is a simple and rapid surgical procedure and an easy method of voice rehabilitation that is associated with only a low rate of complications. The literature describes only a few cases of severe life-threatening complications such as oesophageal perforation with mediastinitis, soft-tissue abscesses, or spinal injuries [1,13,25]. In contrast, minor local problems occur more often and include the formation of biofilms on the prosthesis with subsequent prosthesis failure, spasms, or stenoses in the cricopharyngeal segment with limited swallowing and voicing as well as granulation tissue formation in the region of the tracheo-oesophageal fistula, periprosthetic leakage as a result of fistula enlargement with subsequent aspiration symptoms [13,14,29,30].…”

Section: Introductionmentioning

confidence: 99%

“…Irrespective of the type of prosthesis, success rates between 85 and 95% have been reported [25,29]. The insertion of a voice prosthesis is a simple and rapid surgical procedure and an easy method of voice rehabilitation that is associated with only a low rate of complications.…”

Section: Introductionmentioning

confidence: 99%

“…Owing to the aspiration of saliva and food, periprosthetic leakage considerably reduces the quality of life of affected patients. Periprosthetic leakage in association with minor fistula enlargement occurs over time in approximately 25-35% of all patients with prosthetic voice rehabilitation [25,29]. Only 5-8% of all patients with voice prostheses, however, have fistulas that are massively enlarged to a diameter of more than 1.5 cm and make oral nutrition impossible [29].…”

Section: Introductionmentioning

confidence: 99%

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The management of periprosthetic leakage in the presence of supra-oesophageal reflux after prosthetic voice rehabilitation

Lorenz¹,

Grieser²,

Ehrhart³

et al. 2010

Eur Arch Otorhinolaryngol

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The objective of the study was to investigate the influence of anti-reflux medications on the management of periprosthetic leakage in laryngectomised patients with prosthetic voice rehabilitation. Sixty patients underwent laryngectomy and prosthetic voice rehabilitation. In a prospective non-randomised study, we examined the patients clinically and assessed the presence of reflux disease using 24-h dual-probe pH monitoring before and 6 months after oral anti-reflux treatment with proton pump inhibitors (PPIs). The severity of reflux, the effectiveness of anti-reflux therapy, and the clinical success of treatment were evaluated. Reflux parameters before and after anti-reflux therapy as well as the severity and incidence of periprosthetic leakage before and after PPI therapy were the main outcome measures. The absolute number of reflux events was 162.2 (±144.3) before treatment and 63.1 (±87.9) after treatment with PPIs (p = 0.031). The reflex area index score decreased from 327.1 (±419.3) without PPIs to 123.8 (±249.7) with PPIs (p = 0.0228). The mean DeMeester score was 108.3 (±85.4) before treatment and 47.4 (±61.7) after 6 months of treatment (p = 0.0557). The relative risk of periprosthetic leakage decreased to 0.5 after anti-reflux treatment. In 19 patients, leakage problems were successfully managed by rigorous treatment with PPIs. No further surgical procedures were required in these cases. Rigorous anti-reflux treatment leads to an improvement in parameters that can be assessed objectively by 24-h dual-probe pH monitoring. In the majority of patients, the symptoms associated with periprosthetic leakage can be improved or cured.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The management of periprosthetic leakage in the presence of supra-oesophageal reflux after prosthetic voice rehabilitation

Lorenz¹,

Grieser²,

Ehrhart³

et al. 2010

Eur Arch Otorhinolaryngol

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“…10 Here we discuss a novel method of speech valve insertion in a patient in whom traditional techniques had failed and placement under general anaesthesia was contraindicated.…”

Section: Introductionmentioning

confidence: 99%

Insertion of a tracheoesophageal speech valve: a novel approach in a difficult situation

et al. 2016

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Background: Functional voice rehabilitation is becoming increasingly important following total laryngectomy and pharyngolaryngectomy. Tracheoesophageal voice via a shunt valve is currently regarded as the 'gold standard' for voice rehabilitation. Traditional techniques usually allow for the replacement of valves in the out-patient setting; however, patient factors such as altered anatomy may occasionally prevent this.Objective: This paper describes a novel approach for speech valve insertion that is safe, quick and cost-effective, and which uses equipment commonly available in ENT wards and the operating theatre.

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“…However, secondary TEP placement may prevent postoperative complications such as fistulas and sequelae due to radiation. Some authors have reported that secondary placement favors a better performance [17,7], whereas others have stated that primary placement is responsible for better results [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Scientific Evidence Regarding the Quality of Life of Total Laryngectomees

Nemr¹,

Acs²,

Tk³

et al. 2015

Arch Otolaryngol Rhinold

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Introduction: The loss of laryngeal voice after total laryngectomy can have an impact on the quality of life and communication of affected individuals. Postoperative phonatory methods may promote advantages in oral communication and reduce the functional, organic and emotional changes experienced by the patients. On this basis, the objective of the present study was to review the literature in order to determine the impact on the quality of life of total laryngectomees according to the form of rehabilitation chosen after the procedure and to identify the protocols most frequently used to assess the quality of life of these individuals.

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Surgical complications of tracheo-oesophageal puncture and speech valves

Cited by 46 publications

References 74 publications

The management of periprosthetic leakage in the presence of supra-oesophageal reflux after prosthetic voice rehabilitation

The management of periprosthetic leakage in the presence of supra-oesophageal reflux after prosthetic voice rehabilitation

Insertion of a tracheoesophageal speech valve: a novel approach in a difficult situation

Scientific Evidence Regarding the Quality of Life of Total Laryngectomees

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