Primary fit tracheoesophageal puncture in primary versus salvage laryngectomy: Short-term and long-term complications and functional outcomes

Emese C Kanyo; Shannon S Wu; Chandana A Reddy; Natalie L Silver; Eric D Lamarre; Brian B Burkey; Brandon L Prendes; Joseph Scharpf; Robert R Lorenz; Joann Kmiecik; Jamie A Ku

doi:10.1002/hed.27788

Primary fit tracheoesophageal puncture in primary versus salvage laryngectomy: Short-term and long-term complications and functional outcomes

Head Neck. 2024 Apr 24. doi: 10.1002/hed.27788. Online ahead of print.

Authors

Affiliations

¹ Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
² Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA.
³ Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.

PMID: 38655707
DOI: 10.1002/hed.27788

Abstract

Background: Primary fit tracheoesophageal puncture (TEP) is widely preferred for individuals who have not undergone prior radiation. However, there is no consensus on the relative utility of primary-fit TEP in the setting of salvage laryngectomy.

Methods: A retrospective, single-center review was conducted of individuals undergoing laryngectomy with primary fit TEP between 2012 and 2018. Multivariable analysis was conducted to compare short-term and long-term complications, as well as speech and swallowing outcomes, of those who underwent primary versus salvage laryngectomy.

Results: In this study, 134 patients underwent total laryngectomy with primary fit TEP. Aside from a higher rate of peristomal dehiscence (13.1% vs. 1.4%) found in the salvage group, there was no difference in incidence of all other complications, including pharyngocutaneous fistula formation. The groups had comparable speech and swallow outcomes.

Conclusion: Primary fit TEP is a safe and effective surgical choice for individuals undergoing salvage laryngectomy who desire a voice prosthesis.

Keywords: functional outcomes; laryngeal cancer; pharyngocutaneous fistula; salvage laryngectomy; tracheoesophageal puncture.