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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.

Parotid duct fistula is uncommon but difficult-to-treat complication that often results from a penetrating trauma. While there is general consensus in the literature as to the management of acute parotid injuries, treatment of chronic fistulas remains controversial. We review the current treatment options for parotid duct fistulas and describe an intraoral diversion technique to reestablish salivary flow in the setting of a nonfunctional parotid duct punctum.

Tetraspanins (or TM4SF) are expressed in a wide variety of species and regulate cell adhesion, migration, proliferation and differentiation. We have identified and sequenced six new members of the tetraspanin family, called Tspan-1-6, from human cDNA. Amino acid sequence analysis of the Tspans highlights conserved residues which may be critical to tetraspanin structure and function. The Tspans are differentially expressed in human tissues.