Abstract
Placement of a voice device in a tracheoesophageal fistula provides successful speech rehabilitation after total laryngectomy. However, in the long term, removal of the voice device and permanent closure of the fistula is sometimes necessary. This paper presents and evaluates a simple surgical technique for primary closure of tracheo-esophageal fistulae. We retrospectively review 12 laryngectomees who received this technique of primary closure from 1997 to 2000. In 58% of the patients, permanent fistula closure could be obtained. Six patients (50%) healed primarily; in one patient (8%) the residual fistula opening healed secondarily. Four patients (33%) needed a second surgical procedure, and in one patient (8%) inserting a new speech prosthesis obliterated the residual fistula. Radiotherapy seems to compromise wound healing and therefore may be considered as a contraindication. Complications such as tracheal stenosis, tissue necrosis and pneumonia, etc., did not occur.
Similar content being viewed by others
References
Brasnu D, Pages JC, Laccourreye O, Jouffre V, Monfrais Pfauwadel MC, Crevier Buchman L (1994) Results of the treatment of spontaneous widening of tracheo-esophageal punctures after laryngeal implant. Ann Otolaryngol Chir Cervicofac 111:456–460
Remacle MJ, Declaye XJ (1988) Gax-collagen injection to correct an enlarged tracheoesphageal fistula for a vocal prosthesis. Laryngoscope 98:1350–1352
Ward PH, Andrews BC, Mickel RA, Hanson DG, Monahan GP (1988) Complications of medical and surgical approaches to voice restoration after total laryngectomy. Head Neck Surg 10 [Suppl II]:S124–128
Blom ED, Hamaker RC, Freeman SB (1994) Postlaryngectomy voice restoration. In: Lucente FE (ed) Highlights of the instructional courses, chap 1. Mosby Year Book, St. Louis
Delaere PR, Delsupehe KG (1994) Closure of persistent tracheoesophageal fistula after removal of the voice prosthesis. Laryngoscope 104:494–496
Siu KF, Wei WI, Lam KH, Wong J (1985) Use of pectoralis maior flaps for repair of traceo-esophageal fistula. Am J Surg 150:617–619
Cuhna-Gomes D, Kavarana NM (2001) The surgical treatment of postlaryngectomy pharyngocutaneous fistulae. Acta Chir Plast 43:115–118
Hosal SA, Myers E (2001) How I do it: closure of tracheoesophageal puncture site. Head Neck 23:214–216
Rosen A, Scher N, Panje WR (1997) Surgical closure of persisting failed tracheoesophageal voice fistula. Ann Otol Rhinol Laryngol 106:775–778
Annyas AA, Escajadillo JR (1984) Closure of tracheoesophageal fistulas after removal of the voice prosthesis. Laryngoscope 94:1244–1245
Acknowledgements
We would like to express our gratitude to F. Cotman and P. Wallaert for preparing the figures.
Author information
Authors and Affiliations
Corresponding author
Additional information
Both first authors contributed equally to this paper.
Rights and permissions
About this article
Cite this article
Moerman, M., Vermeersch, H. & Heylbroeck, P. A simple surgical technique for tracheoesophageal fistula closure. Eur Arch Otorhinolaryngol 261, 381–385 (2004). https://doi.org/10.1007/s00405-003-0693-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-003-0693-9