April 1, 2006 Christopher Y. Chang, MD; Richard L. Scher, MD
April 1, 2006 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
article
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.
April 1, 2006 Timothy D. Anderson, MD; Steven F. Nezhad, MD
March 1, 2006 Giovana R. Thomas, MD; Tiffany Raynor, MD
article
Abstract
Complete esophageal stenosis secondary to peptic stricture in the upper esophagus is rare. It is, however, a serious medical problem that may require otolaryngologic intervention because of life-threatening dysphagia and weight loss. We report the case of an elderly patient who presented with an upper esophageal stricture, without the typical symptoms of gastroesophageal reflux disease, that progressed to complete esophageal obstruction despite use of proton pump inhibitors and esophageal dilatation. Definitive management of this difficult problem required esophagectomy and gastric pull-up. We discuss the pathophysiology, clinical presentation, differential diagnosis, and multidisciplinary management of peptic esophageal strictures. This case illustrates the difficulty in managing high peptic strictures.
February 1, 2006 William H. Moretz III, MD; Gregory N. Postma, MD; Lori M. Burkhead, PhD, CCC-SLP; Aparna Balan, PhD, CCC-SLP
December 1, 2005 Justin S. Golub, BA; Michael M. Johns III, MD
September 30, 2005 S. Punjab Gupta, MD; Daniel J. Kirse, MD; Gregory N. Postma, MD; Peter C. Belafsky, MD
February 1, 2005 Stacey L. Halum, MD; Susan G. Butler, PhD, CCC-SLP; Jamie A. Koufman, MD; Gregory N. Postma, MD
December 1, 2004 Gregory N. Postma, MD; Susan G. Butler, PhD, CCC-SLP; Peter C. Belafsky, MD, PhD; Stacey L. Halum, MD
September 30, 2004 Susan G. Butler, PhD, CCC-SLP; Gregory N. Postma, MD
June 30, 2004 C. Blake Simpson, MD; Milan R. Amin, MD
