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Primary tracheoesophageal puncture and cricopharyngeal myotomy in stapler-assisted total laryngectomy

Published online by Cambridge University Press:  26 May 2016

D M Beswick  and
E J Damrose
D M Beswick
Affiliation:
Department of Otolaryngology / Head and Neck Surgery, Stanford University School of Medicine, California, USA
E J Damrose*
Affiliation:
Department of Otolaryngology / Head and Neck Surgery, Stanford University School of Medicine, California, USA
*
Address for correspondence: Dr Edward J Damrose, Department of Otolaryngology / Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA Fax: +1 650 725 8502 E-mail: edamrose@stanford.edu
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Abstract

Objective:

To evaluate the utility of the hybrid tracheoesophageal puncture procedure in stapler-assisted laryngectomy.

Methods:

Patients who underwent total laryngectomy at a single institution from 2009 to 2015 were reviewed. The interventions assessed were surgical creation of a tracheoesophageal puncture and placement of a voice prosthesis. The outcomes measured included voicing ability and valve failure.

Results:

Thirty-nine patients underwent total laryngectomy or pharyngolaryngectomy. Of these, nine underwent stapler-assisted laryngectomy; seven of the nine patients underwent concurrent stapler-assisted laryngectomy, cricopharyngeal myotomy and a hybrid tracheoesophageal puncture procedure. These seven patients were the focus of this review. Successful voicing and oral alimentation was achieved in all patients. Mean time to phonation was 30 days (range, 7–77 days) and mean time to first valve change was 90 days (range, 35–117 days).

Conclusion:

Primary tracheoesophageal puncture with concurrent voice prosthesis placement and cricopharyngeal myotomy is easily performed with stapler-assisted laryngectomy. The hybrid tracheoesophageal puncture procedure is a simple method that enables a single operator to achieve primary tracheoesophageal puncture and valve placement; in addition, it facilitates concurrent cricopharyngeal myotomy.

Keywords

LarynxLaryngectomySurgical StaplersPuncturesVoiceNeoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 7 , July 2016 , pp. 686 - 690
Copyright
Copyright © JLO (1984) Limited 2016 

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Footnotes

Presented at the Combined Otolaryngology Spring Meetings, 14–18 May 2014, Las Vegas, Nevada, USA.

References

1Singer, MI, Blom, ED.An endoscopic technique for restoration of voice after laryngectomy. Ann Otol Rhinol Laryngol 1980;89:529–33Google Scholar
2Maves, MD, Lingeman, RE.Primary vocal rehabilitation using the Blom-Singer and Panje voice prostheses. Ann Otol Rhinol Laryngol 1982;91:458–60Google Scholar
3Hamaker, RC, Singer, MI, Blom, ED, Daniels, HA.Primary voice restoration at laryngectomy. Arch Otolaryngol 1985;111:182–6Google Scholar
4Juarbe, C, Shemen, L, Eberle, R, Klatsky, I, Fox, M.Primary tracheoesophageal puncture for voice restoration. Am J Surg 1986;152:464–6Google Scholar
5Lau, WF, Wei, WI, Ho, CM, Lam, KH.Immediate tracheoesophageal puncture for voice restoration in laryngopharyngeal resection. Am J Surg 1988;156:269–72CrossRefGoogle ScholarPubMed
6Elmiyeh, B, Dwivedi, RC, Jallali, N, Chisholm, EJ, Kazi, R, Clarke, PM et al. Surgical voice restoration after total laryngectomy: an overview. Indian J Cancer 2010;47:239–47Google Scholar
7Halevy, A, Sade, J.The use of thoracoabdominal staplers in ENT surgery. Arch Otorhinolaryngol 1983;237:185–90Google Scholar
8Wolfensberger, M, Simmen, D.Staple closure of the hypopharynx after diverticulectomy and total laryngectomy. Dysphagia 1991;6:26–9Google Scholar
9Bedrin, L, Ginsburg, G, Horowitz, Z, Talmi, YP.25-year experience of using a linear stapler in laryngectomy. Head Neck 2005;27:1073–109Google Scholar
10Altissimi, G, Frenguelli, A.Linear stapler closure of the pharynx during total laryngectomy: a 15-year experience (from closed technique to semi-closed technique). Acta Otorhinolaryngol Ital 2007;27:118–22Google ScholarPubMed
11Ahsan, F, Ah-See, KW, Hussain, A.Stapled closed technique for laryngectomy and pharyngeal repair. J Laryngol Otol 2008;122:1245–8Google Scholar
12Gonçalves, AJ, de Souza, JA Jr, Menezes, MB, Kavabata, NK, Suehara, AB, Lehn, CN.Pharyngocutaneous fistulae following total laryngectomy comparison between manual and mechanical sutures. Eur Arch Otorhinolaryngol 2009;266:1793–8CrossRefGoogle ScholarPubMed
13Calli, C, Pinar, E, Oncel, S.Pharyngocutaneous fistula after total laryngectomy: less common with mechanical stapler closure. Ann Otol Rhinol Laryngol 2011;120:339–44Google Scholar
14Sannikorn, P, Pornniwes, N.Comparison of outcomes for staple and conventional closure of the pharynx following total laryngectomy. J Med Assoc Thai 2013;96(suppl 3):S89–93Google Scholar
15Zhang, X, Liu, Z, Li, Q, Liu, X, Li, H, Liu, W et al. Using a linear stapler for pharyngeal closure in total laryngectomy. Eur Arch Otorhinolaryngol 2013;270:1467–71Google Scholar
16Aires, FT, Dedivitis, RA, Castro, MA, Bernardo, WM, Cernea, CR.Efficacy of stapler pharyngeal closure after total laryngectomy: a systematic review. Head Neck 2014;36:739–42Google Scholar
17Dedivitis, RA, Aires, FT, Pfuetzenreiter, EG Jr, Castro, MA, Guimarães, AV.Stapler suture of the pharynx after total laryngectomy. Acta Otorhinolaryngol Ital 2014;34:94–8Google Scholar
18Leahy, KP, Tufano, RP.Primary tracheoesophageal puncture in stapler-assisted total laryngectomy. ORL J Otorhinolaryngol Relat Spec 2010;72:124–6Google Scholar
19Damrose, EJ, Cho, DY, Goode, RL.The hybrid tracheoesophageal puncture procedure: indications and outcomes. Ann Otol Rhinol Laryngol 2014;123:584–90Google Scholar
20Hoehn, JG, Payne, WS.Resection of pharyngoesophageal diverticulum using stapling device. Mayo Clin Proc 1969;44:738–41Google Scholar
21Chodosh, PL.Cricopharyngeal myotomy in the treatment of dysphagia. Laryngoscope 1975;85:1862–73Google Scholar
22Maniglia, AJ.Vocal rehabilitation after total laryngectomy: a flexible fiberoptic endoscopic technique for tracheoesophageal fistula. Laryngoscope 1982;92:1437–9CrossRefGoogle ScholarPubMed
23Cannon, CR.Using an endotracheal tube in difficult secondary tracheoesophageal puncture: a novel technique. Otolaryngol Head Neck Surg 2001;125:117–19Google Scholar