Sethi RKV, et al. - During this study, the national trends in primary tracheoesophageal puncture (TEP) were investigated by the authors. They also determined the factors related to its use. As per findings, primary TEP correlated with earlier voice restoration after total laryngectomy (TL). However, it was infrequently carried out. Maximum primary TEPs were conducted in teaching hospitals. A link was disclosed between primary TEP with concurrent cricopharyngeal myotomy. Practice patterns associated with primary TEP warranted additional testing.