• Elaine Cheng, Margie Ho, Cindy Ganz, Ashok Shaha, Jay O Boyle, Bhuvanesh Singh, Richard J Wong, Snehal Patel, Jatin Shah, Ryan C Branski, and Dennis H Kraus.
• Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York City, NY 10021, USA.
• Ear Nose Throat J. 2006 Apr 1; 85 (4): 262, 264-7.

AbstractThe current study retrospectively reviewed the cases of 68 patients who had undergone total laryngectomy and tracheoesophageal puncture (TEP) over a 16-year period. Fifty-one patients underwent primary TEP and 17 underwent secondary TEP. Nearly 80% of patients who received TEP at the time of laryngectomy achieved excellent voice quality perceptually. In contrast, only 50% of secondary TEP patients achieved excellent voice ratings. This difference was statistically robust (p = 0.03). Although both surgical and prosthesis-related complications occurred more frequently following primary TEP, statistically significant differences were not achieved. Neither pre- nor postoperative radiotherapy had any effect on voice restoration or complication rates. Based on these data, primary TEP may be preferable for several reasons, including a greater likelihood of successful voice restoration, a shorter duration of postoperative aphonia, and the elimination of the need for a second operation and interim tube feedings.

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