Outcomes of tracheoesophageal puncture in twice-radiated patients.
Am J Otolaryngol
; 40(6): 102272, 2019.
Article
em En
| MEDLINE
| ID: mdl-31445930
ABSTRACT
OBJECTIVE:
Previous research has demonstrated the safety of tracheoesophageal puncture voice prosthesis (TEP) placement in radiated patients; however, there is a growing population of twice-radiated patients with limited research on the outcomes of TEP-placement in this cohort.METHODS:
After Institutional Review Board approval, a retrospective review of 80 patients that underwent TEP from 2006 to 2017 at a single institution was conducted, of which 16 patients underwent two courses of radiation. Outcome measures include TEP removal, complication and duration of usage.RESULTS:
Half of twice-radiated patients had ultimate removal of their voice prosthesis with removal occurring at a median of 24.9â¯months after placement. Reasons for prosthesis removal included widening tracheoesophageal fistula, local recurrence, and dysphagia/esophageal stenosis. Nearly one-third of these patients required surgical intervention for closure of a widening fistula. In contrast, only 17% of once-radiated patients had their prosthesis removed with removal occurring at a median of 28.1â¯months. This was statistically fewer than the twice-radiated group (pâ¯=â¯0.02). Reasons for removal included patient preference, persistent leakage, recurrence of disease, enlarging tracheoesophageal fistula, poor voice, and dysphagia. Eleven percent of once-radiated patients required surgical intervention for TEP-related complications (pâ¯=â¯0.057).CONCLUSION:
In the twice-radiated patient cohort, there is a higher rate of TEP removal and need for surgical intervention for a voice prosthesis-related complication as compared to a once-radiated cohort.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Traqueia
/
Punções
/
Neoplasias Laríngeas
/
Implantação de Prótese
/
Esôfago
/
Laringe Artificial
Tipo de estudo:
Observational_studies
Limite:
Adult
/
Aged
/
Female
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Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article