1. Post-laryngectomy voice rehabilitation: comparison of primary and secondary tracheoesophageal puncture.
- Author
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Guttman D, Mizrachi A, Hadar T, Bachar G, Hamzani Y, Marx S, and Shvero J
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Chemoradiotherapy adverse effects, Chemoradiotherapy methods, Female, Humans, Male, Middle Aged, Punctures, Retrospective Studies, Time Factors, Treatment Outcome, Voice Quality, Young Adult, Hypopharyngeal Neoplasms surgery, Laryngeal Neoplasms surgery, Laryngectomy methods, Larynx, Artificial, Voice Disorders rehabilitation
- Abstract
Background: Voice restoration following total laryngectomy is an important part of patients' rehabilitation and long-term quality of life., Objectives: To evaluate the long-term outcome of indwelling voice prostheses inserted during (primary procedure) or after (secondary procedure) total laryngectomy., Methods: The study group included 90 patients who underwent total laryngectomy and tracheoesophageal puncture (TEP) with placement of voice prosthesis at a tertiary medical center during the period 1990-2008. Background, clinical and outcome data were collected by medical file review. Findings were compared between patients in whom TEP was performed as a primary or a secondary procedure., Results: TEP was performed as a primary procedure in 64 patients and a secondary procedure in 26. Corresponding rates of satisfactory voice rehabilitation were 84.4% and 88.5% respectively. There was no association of voice quality with either receipt of adjuvant radiation/chemoradiation or patient age. The average lifetime of the voice prosthesis was 4.2 months for primary TEP and 9.06 months for secondary TEP (P= 0.025)., Conclusions: Primary TEP provides almost immediate and satisfactory voice rehabilitation. However, it is associated with a significantly shorter average prosthesis lifetime than secondary TEP. Chemoradiotherapy and patient age do not affect voice quality with either procedure.
- Published
- 2013