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Outcomes of primary and secondary tracheoesophageal puncture: A 16-year retrospective analysis

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April 1, 2006
by Elaine Cheng, MD; Margie Ho, MA; Cindy Ganz, MS; Ashok Shaha, MD; Jay O. Boyle, MD; Bhuvanesh Singh, MD; Richrd J. Wong, MD; Snehal Patel, MD; Jatin Shah, MD; Ryan C. Branski, PhD; Dennis H. Kraus, MD
Abstract
The current study retrospectively reviewed the cases of 68 patients who had undergone total laryngectomy and tracheoesophageal puncture (TEP) over a 16-year period. Fifty-one patients underwent primary TEP and 17 underwent secondary TEP. Nearly 80% of patients who received TEP at the time of laryngectomy achieved excellent voice quality perceptually. In contrast, only 50% of secondary TEP patients achieved excellent voice ratings. This difference was statistically robust (p = 0.03). Although both surgical and prosthesis-related complications occurred more frequently following primary TEP, statistically significant differences were not achieved. Neither pre- nor postoperative radiotherapy had any effect on voice restoration or complication rates. Based on these data, primary TEP may be preferable for several reasons, including a greater likelihood of successful voice restoration, a shorter duration of postoperative aphonia, and the elimination of the need for a second operation and interim tube feedings.

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