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Influence of timing, radiation, and reconstruction on complications and speech outcomes with tracheoesophageal puncture
Author(s) -
Gitomer Sarah A.,
Hutcheson Katherine A.,
Christianson Brandon L.,
Samuelson Madeleine B.,
Barringer Denise A.,
Roberts Dianna B.,
Hessel Amy C.,
Weber Randal S.,
Lewin Jan S.,
Zafereo Mark E.
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24529
Subject(s) - medicine , surgery , radiation therapy , head and neck , retrospective cohort study
Abstract Background We evaluated the impact of radiation, reconstruction, and timing of tracheoesophageal puncture (TEP) on complications and speech outcomes. Methods Retrospective review identified 145 patients who underwent TEP between 2003 and 2007. Results Ninety‐nine patients (68%) had primary and 46 (32%) had secondary TEP, with complications occurring in 65% and 61%, respectively ( p = .96). Twenty‐nine patients (20%) had major complications (18 primary and 11 secondary; p = .42). Ninety‐four patients (65%) had pre‐TEP radiation, 39 (27%) post‐TEP radiation, and 12 (8%) no radiation. With patients grouped by TEP timing and radiation history, there was no difference in complications, fluency, or TEP use. With mean 4.7‐year follow‐up, 82% primary and 85% secondary used TEP for primary communication ( p = .66). Free‐flap patients used TEP more commonly for primary communication after secondary versus primary TEP (90% vs 50%; p = .02). Conclusion Primary and secondary tracheoesophageal speakers experience similar high rates of complications. Extent of pharyngeal reconstruction, rather than radiation, may be more important in selection of TEP timing. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1765–1771, 2016