Our Summary

This research paper covers a new method developed to fix a type of hole that can occur in the throat area after a procedure used to restore voice function following a total removal of the voice box. The new technique is simple and effective, doesn’t involve using additional tissues or materials, and allows for a quick recovery time for swallowing and a short hospital stay. The paper discusses the benefits of this method, potential issues, and mistakes to avoid. However, the technique should not be used for patients who have had radiation treatment and those with large throat holes.

FAQs

  1. What is the purpose of a tracheoesophageal puncture with voice prosthesis placement after a total laryngectomy?
  2. Who are not suitable candidates for the technique developed in your department for fistula closure after laryngectomy?
  3. What are the benefits of the newly developed technique for fistula closure post-laryngectomy?

Doctor’s Tip

A doctor may advise a patient who has undergone a laryngectomy to carefully monitor their stoma site for any signs of infection or irritation. It is important to keep the area clean and dry to prevent any complications. Additionally, staying hydrated and performing regular exercises to strengthen the muscles in the throat can help improve swallowing function and overall quality of life after surgery.

Suitable For

Patients who have undergone total laryngectomy and have developed a tracheoesophageal fistula are typically recommended for laryngectomy closure. This procedure is particularly beneficial for patients who have not responded well to voice prosthesis placement or who have complications related to the fistula. It is important to note that this procedure may not be suitable for patients who have been irradiated or who have large fistulas. Additionally, patients who are not medically stable or who have other underlying health conditions may not be good candidates for laryngectomy closure.

Timeline

Timeline before laryngectomy:

  1. Diagnosis of laryngeal cancer or other condition requiring laryngectomy
  2. Consultation with a healthcare provider to discuss treatment options
  3. Preoperative testing and preparations for surgery
  4. Surgical procedure to remove the larynx (total laryngectomy)

Timeline after laryngectomy:

  1. Recovery period in the hospital
  2. Rehabilitation and adjustment to living without a larynx
  3. Evaluation for tracheoesophageal puncture with voice prosthesis placement
  4. Procedure to insert voice prosthesis and start voice rehabilitation
  5. Follow-up appointments for monitoring and adjustments to the voice prosthesis
  6. Potential closure of the fistula if needed
  7. Continued speech therapy and support to improve communication and swallowing abilities

What to Ask Your Doctor

  1. Can you explain the tracheoesophageal puncture procedure and how a voice prosthesis works?
  2. How likely is it that I will need to have the fistula closed after the tracheoesophageal puncture procedure?
  3. What are the risks and complications associated with fistula closure?
  4. What is the expected recovery time and rehabilitation process after fistula closure?
  5. Are there any specific factors or conditions that would make me ineligible for this closure procedure?
  6. How often will I need to follow up with you after the fistula closure?
  7. Can you explain any potential side effects or changes in vocal function that may occur after the closure procedure?
  8. Are there any lifestyle or dietary changes I should make to support healing after the closure procedure?
  9. What should I do if I experience any problems or complications after the closure procedure?
  10. Are there any alternative treatments or procedures that I should consider for restoring vocal function after laryngectomy?

Reference

Authors: Riva G, Dagna F, Ricci E, Cavalot AL. Journal: Otolaryngol Head Neck Surg. 2019 Aug;161(2):368-370. doi: 10.1177/0194599819842159. Epub 2019 Apr 16. PMID: 30987520