Complications following tracheoesophageal puncture

A tertiary hospital experience

Pengiran Suhaili Dayangku Norsuhazenah, Marina Mat Baki, Mohd. Razif Mohamad Yunus, Primuharsa Putra Sabir Husin Athar, Abdullah Sani Mohamed

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Introduction: In laryngectomised patients, tracheoesophageal speech is the gold standard for voice rehabilitation. This study evaluated complications related to the tracheoesophageal puncture (TEP) and the success rate in voice prosthesis after total laryngectomy at our institution over a 10-year period. Materials and Methods: A retrospective review of 22 TEPs was performed between January 1998 and December 2008. The timing of TEP, type of voice prosthesis, surgical and prosthesis-related complications, and TEP closure were noted. Results: Eighteen percent of the patients underwent primary and 82% secondary TEP. Our patients were predominantly males (95.4%) of Chinese descent with a mean age of 62.1 years. The types of voice prostheses used were Provox™ (n = 15), Voicemasters (n = 6), and Blom-Singer (n = 1). Prosthesis- related complications occurred in 77.3%. Notable complications were leakage (82.5%), prosthesis displacement (41.2%), intractable aspiration (29.4%), and aspiration of prosthesis (23.5%). The most common surgical-related complication was tracheostomal stenosis. An array of interventions comprising resizing or changing prosthesis type, nasogastric catheter insertion, stomaplasty, purse string suturing, and bronchoscopic removal of bronchial aspirated prosthesis were implemented to address encountered complications. In a mean follow-up of 34.8 months, 68.2% of patients achieved functional tracheoesophageal speech (75% of primary TEP and 67% of secondary TEP). There were 7 TEP closures indicated by persistent leakage, recurrent dislodgement, phonatory failure and, in 1 patient, persistent pain. Conclusions: TEP has become an integral part in the rehabilitation of a laryngectomee. However, management of the frequent complications related to TEP requires specifi c efforts and specialistic commitments in order to treat them.

Original languageEnglish
Pages (from-to)565-568
Number of pages4
JournalAnnals of the Academy of Medicine Singapore
Volume39
Issue number7
Publication statusPublished - 2010

Fingerprint

Punctures
Tertiary Care Centers
Prostheses and Implants
Artificial Larynges
Rehabilitation
Singing
Laryngectomy
Pathologic Constriction
Catheters
Pain

Keywords

  • Total laryngectomy
  • Voice prosthesis rehabilitation
  • Voice rehabilitation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Complications following tracheoesophageal puncture : A tertiary hospital experience. / Dayangku Norsuhazenah, Pengiran Suhaili; Mat Baki, Marina; Mohamad Yunus, Mohd. Razif; Sabir Husin Athar, Primuharsa Putra; Mohamed, Abdullah Sani.

In: Annals of the Academy of Medicine Singapore, Vol. 39, No. 7, 2010, p. 565-568.

Research output: Contribution to journalArticle

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title = "Complications following tracheoesophageal puncture: A tertiary hospital experience",
abstract = "Introduction: In laryngectomised patients, tracheoesophageal speech is the gold standard for voice rehabilitation. This study evaluated complications related to the tracheoesophageal puncture (TEP) and the success rate in voice prosthesis after total laryngectomy at our institution over a 10-year period. Materials and Methods: A retrospective review of 22 TEPs was performed between January 1998 and December 2008. The timing of TEP, type of voice prosthesis, surgical and prosthesis-related complications, and TEP closure were noted. Results: Eighteen percent of the patients underwent primary and 82{\%} secondary TEP. Our patients were predominantly males (95.4{\%}) of Chinese descent with a mean age of 62.1 years. The types of voice prostheses used were Provox™ (n = 15), Voicemasters (n = 6), and Blom-Singer (n = 1). Prosthesis- related complications occurred in 77.3{\%}. Notable complications were leakage (82.5{\%}), prosthesis displacement (41.2{\%}), intractable aspiration (29.4{\%}), and aspiration of prosthesis (23.5{\%}). The most common surgical-related complication was tracheostomal stenosis. An array of interventions comprising resizing or changing prosthesis type, nasogastric catheter insertion, stomaplasty, purse string suturing, and bronchoscopic removal of bronchial aspirated prosthesis were implemented to address encountered complications. In a mean follow-up of 34.8 months, 68.2{\%} of patients achieved functional tracheoesophageal speech (75{\%} of primary TEP and 67{\%} of secondary TEP). There were 7 TEP closures indicated by persistent leakage, recurrent dislodgement, phonatory failure and, in 1 patient, persistent pain. Conclusions: TEP has become an integral part in the rehabilitation of a laryngectomee. However, management of the frequent complications related to TEP requires specifi c efforts and specialistic commitments in order to treat them.",
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T1 - Complications following tracheoesophageal puncture

T2 - A tertiary hospital experience

AU - Dayangku Norsuhazenah, Pengiran Suhaili

AU - Mat Baki, Marina

AU - Mohamad Yunus, Mohd. Razif

AU - Sabir Husin Athar, Primuharsa Putra

AU - Mohamed, Abdullah Sani

PY - 2010

Y1 - 2010

N2 - Introduction: In laryngectomised patients, tracheoesophageal speech is the gold standard for voice rehabilitation. This study evaluated complications related to the tracheoesophageal puncture (TEP) and the success rate in voice prosthesis after total laryngectomy at our institution over a 10-year period. Materials and Methods: A retrospective review of 22 TEPs was performed between January 1998 and December 2008. The timing of TEP, type of voice prosthesis, surgical and prosthesis-related complications, and TEP closure were noted. Results: Eighteen percent of the patients underwent primary and 82% secondary TEP. Our patients were predominantly males (95.4%) of Chinese descent with a mean age of 62.1 years. The types of voice prostheses used were Provox™ (n = 15), Voicemasters (n = 6), and Blom-Singer (n = 1). Prosthesis- related complications occurred in 77.3%. Notable complications were leakage (82.5%), prosthesis displacement (41.2%), intractable aspiration (29.4%), and aspiration of prosthesis (23.5%). The most common surgical-related complication was tracheostomal stenosis. An array of interventions comprising resizing or changing prosthesis type, nasogastric catheter insertion, stomaplasty, purse string suturing, and bronchoscopic removal of bronchial aspirated prosthesis were implemented to address encountered complications. In a mean follow-up of 34.8 months, 68.2% of patients achieved functional tracheoesophageal speech (75% of primary TEP and 67% of secondary TEP). There were 7 TEP closures indicated by persistent leakage, recurrent dislodgement, phonatory failure and, in 1 patient, persistent pain. Conclusions: TEP has become an integral part in the rehabilitation of a laryngectomee. However, management of the frequent complications related to TEP requires specifi c efforts and specialistic commitments in order to treat them.

AB - Introduction: In laryngectomised patients, tracheoesophageal speech is the gold standard for voice rehabilitation. This study evaluated complications related to the tracheoesophageal puncture (TEP) and the success rate in voice prosthesis after total laryngectomy at our institution over a 10-year period. Materials and Methods: A retrospective review of 22 TEPs was performed between January 1998 and December 2008. The timing of TEP, type of voice prosthesis, surgical and prosthesis-related complications, and TEP closure were noted. Results: Eighteen percent of the patients underwent primary and 82% secondary TEP. Our patients were predominantly males (95.4%) of Chinese descent with a mean age of 62.1 years. The types of voice prostheses used were Provox™ (n = 15), Voicemasters (n = 6), and Blom-Singer (n = 1). Prosthesis- related complications occurred in 77.3%. Notable complications were leakage (82.5%), prosthesis displacement (41.2%), intractable aspiration (29.4%), and aspiration of prosthesis (23.5%). The most common surgical-related complication was tracheostomal stenosis. An array of interventions comprising resizing or changing prosthesis type, nasogastric catheter insertion, stomaplasty, purse string suturing, and bronchoscopic removal of bronchial aspirated prosthesis were implemented to address encountered complications. In a mean follow-up of 34.8 months, 68.2% of patients achieved functional tracheoesophageal speech (75% of primary TEP and 67% of secondary TEP). There were 7 TEP closures indicated by persistent leakage, recurrent dislodgement, phonatory failure and, in 1 patient, persistent pain. Conclusions: TEP has become an integral part in the rehabilitation of a laryngectomee. However, management of the frequent complications related to TEP requires specifi c efforts and specialistic commitments in order to treat them.

KW - Total laryngectomy

KW - Voice prosthesis rehabilitation

KW - Voice rehabilitation

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JO - Annals of the Academy of Medicine, Singapore

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