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Secondary tracheoesophageal puncture after laryngectomy increases complications with shunt and voice prosthesis

The Laryngoscope Feb 14, 2020

Scherl C, Kauffels J, Schützenberger A, et al. - In patients undergoing placement of voice prosthesis following cancer treatment, researchers conducted this retrospective analysis to assess the demographics, clinical characteristics, management, and prognostic indicators of tracheoesophageal puncture complications. One hundred fourteen cases from a tertiary referral center diagnosed between 1996 and 2015. To determine factors related to tracheoesophageal puncture (TEP) and voice prostheses–complication-free survival (TEP/VP-CFS), multivariate logistic regression was used. Complications were common with TEP. The most frequent problem was salivary leakage, which was the most common reason for changing the prosthesis at the same time. Predictors of poor TEP/VP-CFS were secondary prosthesis placement after primary surgery, placement after previous irradiation, and laryngectomy with flap reconstruction. Planned adjuvant radiotherapy is not a contraindication for TEP with prosthetic placement, but the positioning of the prosthesis during primary surgery or at least prior to scheduled radiotherapy is very necessary.
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