Secondary TEP Placement in Office

Abstract

Objectives:

Evaluate the use and outcomes of in-office secondary tracheoesophageal puncture (TEP) technique using trans-nasal esophagoscopy (TNE) and the Seldinger technique for placement, in a large series of patients having undergone laryngectomy and laryngopharyngectomy.

Methods:

A retrospective chart review at a single institution was performed on 83 subjects who underwent in-office secondary TEP procedure. Variables that were examined included disease site, staging, histology, extent of resection and reconstruction, chemoradiation, functional voice status (as assessed by speech pathologist in most recent note), and complications directly related to the procedure.

Results:

83 individuals from our institution met our criteria for in-office secondary TEP placement from 2006 to 2012. The overall complication rate was 2.4% (2/83). Complications included one patient with bleeding from the puncture site, and another who had closure of puncture site before initial TEP placement. At the time of most recent follow-up, voicing was achieved in 91% of all patients with a TEP (74/81) with 75.3% (61/81) having a fully functional voice as defined as regular use of their TEP for conversational speech.

Conclusions:

These results justify the regular use of in-office TEP performed using TNE and the Seldinger technique. This technique avoids the need for a general anesthetic and has results which compare favorably with other methods of placement.