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Tracheo Esophageal Prosthesis Insertion Under Endoscopic Guidance and Local Anaesthesia- Feasibility and Outcome

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Objectives

Voice rehabilitation after laryngectomy is by tracheo esophageal puncture (TEP) and prosthesis insertion. Secondary TEP is very difficult due to neck fibrosis. Puncture under local anaesthesia with endoscopy guidance is a feasible option.

Methods

Retrospective review of all laryngectomy patients from March 2009 till March 2019 was done and the methods of voice rehabilitation were assessed. The patients undergoing the procedure were classified according to the timing of insertion and type as primary insertion under general anaesthesia (Group P), secondary insertion under local anaesthesia (Group L), secondary insertion under general anaesthesia (Group G). The speech outcome and the procedure outcome were compared.

Results

There were 148 patients who underwent laryngectomy, of which groups P, G, L were 12, 12 and 11. The rate of successful insertion was 100% in primary, 91.6% in secondary in general anaesthesia and 91% in secondary under local anaesthesia. All secondary TEP were done after surgery and radiotherapy. Complications related to the insertion techniques were minimal. Speech outcome were similar on intelligibility rating scale and longevity was not affected by the method.

Conclusion

TEP in local anaesthesia is feasible and has comparable outcome with TEP in general anaesthesia. Financial burden was very much less in group L compared to the other two groups.

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Acknowledgement

We acknowledge the contribution made by Mr. Aneeth, speech and language pathologist for the speech analysis of patients using speech intelligibility scale.

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Authors and Affiliations

  1. Dept of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India

    Sajith Babu Thavarool

  2. Fellow in Head and Neck Oncology, Dept of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kerala, 670103, India

    Sandeep Vijay

  3. Fellow in Head and Neck Oncology, Dept of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India

    Manu S, Naveen George & Raveena R. Nair

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  1. Sajith Babu Thavarool
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  2. Sandeep Vijay
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  3. Manu S
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Correspondence to Sandeep Vijay.

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Thavarool, S.B., Vijay, S., S, M. et al. Tracheo Esophageal Prosthesis Insertion Under Endoscopic Guidance and Local Anaesthesia- Feasibility and Outcome. Indian J Otolaryngol Head Neck Surg 74, 39–44 (2022). https://doi.org/10.1007/s12070-020-02149-5

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  • DOI: https://doi.org/10.1007/s12070-020-02149-5

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