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Research by D.G. Deschler and colleagues in laryngectomy provides new insights
2009 AUG 24 - (NewsRx.com) -- According to recent research from the United States, "Primary tracheoesophageal puncture (TEP) is a well-described and accepted method of surgical voice restoration and is standardly completed with a catheter placement intraoperatively, which is replaced with a prosthesis at a later date. This study evaluates the intraoperative placement of the voice prosthesis at the time of the primary TEP in an effort to understand the potential advantages and disadvantages of voice prosthesis placement at the time of primary TEP completed in conjunction with total laryngectomy." "Retrospective chart review within an academic medical center. After approval by the institutional review board of the Massachusetts Eye and Ear Infirmary, a retrospective chart review was completed of all cases of primary tracheoesophageal prosthesis placement completed in conjunction with primary tracheoesophageal puncture performed at the time of total laryngectomy. Thirty patients were identified, 29 of whom underwent laryngectomy for advanced laryngeal carcinoma. Twenty-eight of 29 patients received preoperative full-dose radiation therapy. Twenty-nine of 30 patients had a 20F classic Indwelling Blom-Singer prosthesis (InHealth Technologies, Carpinteria, CA) placed. One had placement of 16F Indwelling Blom-Singer prosthesis. No complications were noted with intraoperative prosthesis placement. No prostheses were dislodged in the postoperative period. Twenty-nine of 30 subjects had initial success with tracheoesophageal voice production. At 1-year follow-up, 23/30 subjects (77%) had successful voice restoration. Five failed because of recurrent disease, one subject never achieved successful voice, and one subject wanted the prosthesis removed although successful voice was achieved. Twenty-three of 25 (92%) disease-free subjects had functional voice restoration at 1-year post-total laryngectomy and primary prosthesis placement. This study demonstrates that the voice prosthesis can be safely and effectively placed intraoperatively at the time of primary TEP and laryngectomy," wrote D.G. Deschler and colleagues. The researchers concluded: "Initial voice acquisition rates were high and long-term success was well within the acceptable range.." Deschler and colleagues published their study in Laryngoscope (Evaluation of Voice Prosthesis Placement at the Time of Primary Tracheoesophageal Puncture with Total Laryngectomy. Laryngoscope, 2009;119(7):1353-1357). For additional information, contact D.G. Deschler, Massachusetts Eye & Ear Infirmary, Dept. of Otolaryngology Head & Neck Surgery, Division Head & Neck Surgery, 243 Charles St., Boston, MA 02114, USA. Publisher contact information for the journal Laryngoscope is: John Wiley & Sons Inc., 111 River St., Hoboken, NJ 07030, USA. Keywords: United States, Boston, Laryngeal Cancer, Laryngeal Carcinoma, Laryngectomy, Laryngoscope, Medical Device, Oncology, Prosthetic, Surgery. This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2009, Clinical Oncology Week via NewsRx.com.
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