Open AccessPrimary Tracheoesophageal Puncture with Supraclavicular Artery Island Flap after Total Laryngectomy or Laryngopharyngectomy
Author(s) -
Sethi Rosh K. V.,
Kozin Elliott D.,
Lam Allen C.,
Emerick Kevin S.,
Deschler Daniel G.
Publication year - 2014
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599814539443
Subject(s) - laryngectomy , medicine , voice prosthesis , prosthesis , surgery , tracheoesophageal fistula , esophagus , larynx
The supraclavicular artery island flap (SCAIF) is increasingly employed for laryngectomy reconstruction with excellent success. Although tracheoesophageal puncture (TEP) with intraoperative prosthesis placement is also positively reported, this is not described in patients following SCAIF. We review our experience with primary TEP with prosthesis placement and voice outcomes in patients after SCAIF reconstruction. Seven patients underwent SCAIF with primary TEP after laryngectomy from 2011 to 2013. Five underwent total laryngectomy (TL) and 2 underwent TL with partial pharyngectomy. All patients had 16 French Indwelling Blom‐Singer prostheses placed intraoperatively without complications. Six patients achieved tracheoesophageal voice (median time = 1.5 months). Two patients required cricopharyngeal segment Botox injections. One patient remained aphonic. One patient developed prosthesis leakage addressed with prosthesis replacement. Our preliminary data demonstrate that similar to free tissue transfer reconstruction, primary TEP with intraoperative placement of the voice prosthesis at the time of SCAIF reconstruction is safe and effective.