Total laryngectomy with primary tracheoesophageal puncture: intraoperative versus delayed voice prosthesis placement

Robinson, Rachelle A. , Simms, Virginia A. , Ward, Elizabeth C. , Barnhart, Molly K. , Chandler, Sophie J. and Smee, Robert I. (2017) Total laryngectomy with primary tracheoesophageal puncture: intraoperative versus delayed voice prosthesis placement. Head and Neck, 39 6: 1138-1144. doi:10.1002/hed.24727


Author Robinson, Rachelle A.
Simms, Virginia A.
Ward, Elizabeth C.
Barnhart, Molly K.
Chandler, Sophie J.
Smee, Robert I.
Title Total laryngectomy with primary tracheoesophageal puncture: intraoperative versus delayed voice prosthesis placement
Journal name Head and Neck   Check publisher's open access policy
ISSN 1097-0347
1043-3074
Publication date 2017-02-23
Sub-type Article (original research)
DOI 10.1002/hed.24727
Open Access Status Not yet assessed
Volume 39
Issue 6
Start page 1138
End page 1144
Total pages 7
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Formatted abstract
Background: Studies support using intraoperative voice prosthesis insertion performed at the time of primary tracheoesophageal puncture (TEP) during laryngectomy. However, none have compared intraoperative voice prosthesis insertion with delayed voice prosthesis insertion. The purpose of this study was to prospectively examine patient, services, and cost benefits of intraoperative versus delayed voice prosthesis placement.

Methods: Voice prosthesis use, duration to the first voice prosthesis change, early communication, and costs were compared between 14 patients who underwent a laryngectomy and who received intraoperative voice prosthesis placement, and 10 patients who underwent initial catheter stenting and then delayed voice prosthesis insertion.

Results: Intraoperative voice prosthesis placement was associated with significantly fewer early device changes (1.4 vs 2), voice prosthesis changes because of resizing (8% vs 80%), longer durations to initial voice prosthesis change (159.7 vs 24.5 days), earlier commencement of voice rehabilitation (13.2 vs 17.6 days), reduced length of hospital stay (17.2 vs 24.5 days), and cost savings of $559.83/person.

Conclusion: Superior clinical and patient benefits are associated with intraoperative voice prosthesis placement during primary TEP.
Keyword Communication
Laryngectomy
Primary puncture
Tracheoesophageal speech
Voice prosthesis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Health and Rehabilitation Sciences Publications
 
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