Primary fit tracheoesophageal puncture in primary versus salvage laryngectomy: Short-term and long-term complications and functional outcomes

Head Neck. 2024 Nov;46(11):2669-2677. doi: 10.1002/hed.27788. Epub 2024 Apr 24.

Abstract

Background: Primary fit tracheoesophageal puncture (TEP) is widely preferred for individuals who have not undergone prior radiation. However, there is no consensus on the relative utility of primary-fit TEP in the setting of salvage laryngectomy.

Methods: A retrospective, single-center review was conducted of individuals undergoing laryngectomy with primary fit TEP between 2012 and 2018. Multivariable analysis was conducted to compare short-term and long-term complications, as well as speech and swallowing outcomes, of those who underwent primary versus salvage laryngectomy.

Results: In this study, 134 patients underwent total laryngectomy with primary fit TEP. Aside from a higher rate of peristomal dehiscence (13.1% vs. 1.4%) found in the salvage group, there was no difference in incidence of all other complications, including pharyngocutaneous fistula formation. The groups had comparable speech and swallow outcomes.

Conclusion: Primary fit TEP is a safe and effective surgical choice for individuals undergoing salvage laryngectomy who desire a voice prosthesis.

Keywords: functional outcomes; laryngeal cancer; pharyngocutaneous fistula; salvage laryngectomy; tracheoesophageal puncture.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Esophagus* / surgery
  • Female
  • Humans
  • Laryngeal Neoplasms* / surgery
  • Laryngectomy* / adverse effects
  • Laryngectomy* / methods
  • Larynx, Artificial
  • Male
  • Middle Aged
  • Postoperative Complications* / epidemiology
  • Punctures*
  • Retrospective Studies
  • Salvage Therapy* / methods
  • Trachea / surgery
  • Treatment Outcome