European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 2, pp 379–383 | Cite as

Management of persistent tracheoesophageal puncture

  • Mohammad Kamal Mobashir
  • Waleed M. Basha
  • Abd ElRaof Said Mohamed
  • Ahmed M. Anany
Head and Neck


Tracheoesophageal puncture with placement of a voice prosthesis (VP) provides successful speech rehabilitation after total laryngectomy. However, enlargement of the tracheoesophageal puncture is a challenging complication as it results in leakage around the VP into the airway and may eventually lead to aspiration pneumonia and respiratory complications. It necessitates removal of the VP and permanent closure of the tracheoesophageal fistula. We present our own experience for surgical closure of persistent tracheoesophageal puncture. A non-controlled prospective study was conducted at the Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Zagazig University Hospitals, Zagazig, Egypt. This study included five patients with an enlarged tracheoesophageal puncture. They had persistent leakage around the VP with resulting recurrent chest infections. None of the patients underwent previous surgical intervention for closure of the tracheoesophageal fistula. This surgical technique involved identification and exposure of the tracheoesophageal fistula tract by blunt dissection and its ligation by non-resorbable sutures at two points close to the posterior wall of the trachea without dividing the fistula tract. The mean follow-up period was 14.4 months. Successful closure of the fistula was achieved in all patients (100 %). All patients tolerated full diet well and had uneventful recovery and no further episodes of aspiration. This surgical technique is simple, easily feasible technically, and effective. It enables early oral feeding and allows a short hospital stay, thus increasing the patient’s comfort.


Enlarged tracheoesophageal puncture Voice prosthesis Speech restoration 


Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Mohammad Kamal Mobashir
    • 1
  • Waleed M. Basha
    • 1
    • 2
  • Abd ElRaof Said Mohamed
    • 1
  • Ahmed M. Anany
    • 1
  1. 1.Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Faculty of MedicineZagazig UniversityZagazigEgypt
  2. 2.ZagazigEgypt

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