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Purpose of Review: Tracheoesophegeal puncture is a reliable and effective method for voice restoration after total laryngectomy. Tracheoesophegeal puncture may be performed primarily at the time of laryngectomy or as a secondary procedure. This paper reviews the current literature on secondary in-office tracheoesophegeal puncture techniques with an emphasis on techniques that can be performed under local anesthesia., Recent Findings: Many techniques for secondary in-office tracheoesophegeal puncture have been described. The majority require some form of intravenous sedation. Transnasal esophagoscopy is now performed routinely in many otolaryngology practices, and can be used to guide tracheoesophegeal puncture placement in an outpatient setting under local anesthesia., Summary: In-office secondary tracheoesophegeal puncture has become more common in recent years. Transnasal esophagoscopy-guided tracheoesophegeal puncture provides excellent visualization of the operative site throughout the procedure. It can be performed quickly, safely, and effectively in an office setting utilizing only local anesthetic.

Purpose of Review: Gunshot wounds to the head and neck result in significant bone and soft tissue loss. These defects pose a challenge to the facial reconstructive surgeon. This paper reviews the current literature on the management of ballistic injuries to the head and neck and outlines a treatment algorithm., Recent Findings: With recent advances in free tissue transfer, early definitive reconstruction of bone and soft tissue deficits with vascularized flaps has become the treatment of choice. Computed tomography angiography of the neck has been shown to be a sensitive, specific, and safe technique in screening for vascular injuries., Summary: Management of ballistic injuries to the head and neck begins with advanced trauma life support protocols. Computed tomography angiography is now widely available and provides an accurate and rapid evaluation of head and neck vasculature. The initial operation aims to establish occlusion, stabilize bone and close soft tissue defects. Serial debridement of wounds with delayed reconstruction has given way to early definitive repair with vascularized tissue. This has led to improved function, fewer operations, and shorter hospital stays.