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

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
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.

Complete esophageal stenosis secondary to peptic stricture in the cervical esophagus: Case report

March 1, 2006     Giovana R. Thomas, MD; Tiffany Raynor, MD
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.

High-resolution esophageal manometry

February 1, 2006     William H. Moretz III, MD; Gregory N. Postma, MD; Lori M. Burkhead, PhD, CCC-SLP; Aparna Balan, PhD, CCC-SLP

Esophageal candidiasis

December 1, 2005     Justin S. Golub, BA; Michael M. Johns III, MD

Eosinophilic esophagitis

September 30, 2005     S. Punjab Gupta, MD; Daniel J. Kirse, MD; Gregory N. Postma, MD; Peter C. Belafsky, MD

Treatment of globus by upper esophageal sphincter injection with botulinum A toxin

February 1, 2005     Stacey L. Halum, MD; Susan G. Butler, PhD, CCC-SLP; Jamie A. Koufman, MD; Gregory N. Postma, MD

Normal pharyngeal and upper esophageal sphincter manometry

December 1, 2004     Gregory N. Postma, MD; Susan G. Butler, PhD, CCC-SLP; Peter C. Belafsky, MD, PhD; Stacey L. Halum, MD

Tracheoesophageal fistula

September 30, 2004     Susan G. Butler, PhD, CCC-SLP; Gregory N. Postma, MD

Hypopharyngeal schwannoma

June 30, 2004     Peter C. Belafsky, MD, PhD; Gregory N. Postma, MD

Office-based procedures for the voice

June 30, 2004     C. Blake Simpson, MD; Milan R. Amin, MD

July 2004 Supplement

June 30, 2004    
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