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Daniel G Deschler - One of the best experts on this subject based on the ideXlab platform.
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placement of a 16 french Voice Prosthesis at the time of secondary tracheoesophageal Voice restoration
American Journal of Otolaryngology, 2015Co-Authors: Matthew R Naunheim, Aaron K Remenschneider, Glenn Bunting, Daniel G DeschlerAbstract:Abstract Purpose Tracheoesophageal Voice restoration (TEVR) has traditionally been described with fistula tract creation, catheter placement, and Prosthesis placement. Prosthesis placement at the time of tracheoesophageal puncture (TEP) utilizing 20-French prostheses has been previously described. Smaller initial prostheses may allow fluent speech with reduced long-term complications, such as widening of the fistula and peri-Prosthesis leakage. This study evaluates the safety and efficacy of the 16-French prostheses placement at the time of secondary TEP. Methods All cases of 16-French tracheoesophageal Voice Prosthesis (TEVP) placement at the time of secondary TEP were reviewed from 1/2011 through 12/2013 at a large academic medical center. Perioperative complications attributable to device placement were recorded, including inability to place Prosthesis, intraoperative complications, post-operative infection, Prosthesis dislodgement, Prosthesis leakage, and inability to obtain Voice. Results Twenty-one patients received placement of a 16-French TEVP at the time of secondary TEP. All prostheses were placed without intraoperative complications. The proportion of patients who had minor complications within the first postoperative month was 23.8%, including leakage through the Prosthesis (3 of 21), granulation tissue near the Prosthesis (1 of 21), retained sheath (1 of 21) and Prosthesis displacement (1 of 21). Leakage and displacement were addressed with change and replacement, respectively. Fluent voicing was achieved in 85.7% patients, with a median time to voicing of 18.5 days. Conclusions Placement of 16-French TEVPs is effective and safe, with an acceptable rate of minor complications attributable to the Prosthesis. Therefore, a smaller Prosthesis may be primarily placed at the time of secondary TEP and is our preference.
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primary placement of a 16 french Voice Prosthesis at the time of tracheoesophageal Voice restoration
Otolaryngology-Head and Neck Surgery, 2014Co-Authors: Matthew R Naunheim, Aaron K Remenschneider, Glenn Bunting, Daniel G DeschlerAbstract:Objectives:Tracheoesophageal Voice restoration (TEVR) has traditionally been described with fistula tract creation, catheter placement, and secondary Prosthesis placement. Successful primary Prosthesis placement at the time of primary or secondary puncture using a 20 French Prosthesis has been previously described. We now wish to evaluate whether 16 French prostheses can be used safely and effectively.Methods:All cases of primary 16 French tracheoesophageal Voice Prosthesis (TEVP) placements at a large academic medical center were retrospectively reviewed from January 2011 through December 2013. Perioperative complications attributable to device placement were recorded. These included inability to place Prosthesis during procedure, intraoperative issues with primary placement, postoperative infection, Prosthesis dislodgement, leakage around/through the Prosthesis, or inability to obtain Voice.Results:Twenty-two patients received primary placement of a 16 French TEVP. All prostheses were successfully place...
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primary tracheoesophageal puncture with supraclavicular artery island flap after total laryngectomy or laryngopharyngectomy
Otolaryngology-Head and Neck Surgery, 2014Co-Authors: Rosh K V Sethi, Elliott D Kozin, Allen C Lam, Kevin S Emerick, Daniel G DeschlerAbstract:The supraclavicular artery island flap (SCAIF) is increasingly employed for laryngectomy reconstruction with excellent success. Although tracheoesophageal puncture (TEP) with intraoperative Prosthesis placement is also positively reported, this is not described in patients following SCAIF. We review our experience with primary TEP with Prosthesis placement and Voice outcomes in patients after SCAIF reconstruction. Seven patients underwent SCAIF with primary TEP after laryngectomy from 2011 to 2013. Five underwent total laryngectomy (TL) and 2 underwent TL with partial pharyngectomy. All patients had 16 French Indwelling Blom-Singer prostheses placed intraoperatively without complications. Six patients achieved tracheoesophageal Voice (median time = 1.5 months). Two patients required cricopharyngeal segment Botox injections. One patient remained aphonic. One patient developed Prosthesis leakage addressed with Prosthesis replacement. Our preliminary data demonstrate that similar to free tissue transfer reconstruction, primary TEP with intraoperative placement of the Voice Prosthesis at the time of SCAIF reconstruction is safe and effective.
Agricio Nubiato Crespo - One of the best experts on this subject based on the ideXlab platform.
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speech rehabilitation after total laryngectomy long term results with indwelling Voice Prosthesis blom singer
PubMed, 2015Co-Authors: Carlos Takahiro Chone, Ana L Spina, Agricio Nubiato Crespo, Flavio M GrippAbstract:Summary To evaluate long-term use of indwelling Blom-Singer Voice Prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). We studied the influence of time of performance of tracheo-esophageal puncture (TEP), use of radiotherapy (XRT), patients’ age and length of follow-up, on the rate of success of use of VP. Study Design: clinical prospective. Material and Method: Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. Both otolaryngologist and speech pathologist evaluated all patients for the vocal functional issues during the follow-up. The relative data on time of placement of VP, time of use of PF, use of XRT, age, length of follow-up and interval of duration of each VP were recorded during the follow-up. Results: There was 87% of patients with primary TEP and 13% with secondary. The follow-up varied from 12 to 87 months, with average of 38 months for primary and 51 months for secondary TEP. There were 59% of patients submitted to XRT. The general rate of success was of 94%. In primary TEP it was of 97% and in the secondary, it was 78% (p=0.07) and after two years, the success rate was of 96% in primary TEP and 75% in secondary TEP (p=0.07). The use of XRT and patient age did not influence the success of use of VP among primary and secondary TEP, independently of length of follow-up. Conclusion: Tendency to greater success rate in Voice rehabilitation after TL with primary TEP was observed. Postoperative XRT and age did not influence success rate.
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primary versus secondary tracheoesophageal puncture for speech rehabilitation in total laryngectomy long term results with indwelling Voice Prosthesis
Otolaryngology-Head and Neck Surgery, 2005Co-Authors: Carlos Takahiro Chone, Ana L Spina, Flavio M Gripp, Agricio Nubiato CrespoAbstract:OBJECTIVE: To evaluate the long-term use of indwelling Blom-Singer Voice Prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). The influence of the timing (primary or secondary) of tracheoesophageal puncture (TEP), use of radiotherapy (xRT), patient age, and length of follow-up were studied to evaluate the success rate of VP use. STUDY DESIGN AND SETTING: Prospective clinical study in a tertiary referral center. Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. All patients were evaluated for vocal functional issues by an otolaryngologist and a speech pathologist at 1 month, then at every 3 months up to 1 year, and then at every 6 months after 1 year of follow-up. The relative data on time of placement of VP, time of VP use, xRT, age, length of follow-up, and life span of each VP were recorded during the follow-up. RESULTS: Eighty-seven percent of the patients underwent primary and 13%, secondary TEP. The follow-up varied from 12 to 87 months, with an average of 38 months for primary and 51 months for secondary TEP. Fifty-nine percent of the patients were submitted to xRT. The general rate of success was 94%, with 97% for primary and 78% (P = 0.07) for secondary TEP; after 2 years, the success rate was 96% for primary and 75% for secondary (P = 0.07) TEP. The use of xRT and patient age had no influence on the success of VP use for primary and secondary TEP, independently of the length of follow-up. CONCLUSIONS: The success rate of Voice rehabilitation with VP was 94%. In primary TEP, the success rate was 97%, whereas in secondary TEP it was 78%; 2 years later, it was 96% and 75%, respectively. A tendency for a higher success rate in Voice rehabilitation after TL was observed in primary TEP. The use of xRT and age of patient had no influence on the success rate.
Carlos Takahiro Chone - One of the best experts on this subject based on the ideXlab platform.
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speech rehabilitation after total laryngectomy long term results with indwelling Voice Prosthesis blom singer
PubMed, 2015Co-Authors: Carlos Takahiro Chone, Ana L Spina, Agricio Nubiato Crespo, Flavio M GrippAbstract:Summary To evaluate long-term use of indwelling Blom-Singer Voice Prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). We studied the influence of time of performance of tracheo-esophageal puncture (TEP), use of radiotherapy (XRT), patients’ age and length of follow-up, on the rate of success of use of VP. Study Design: clinical prospective. Material and Method: Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. Both otolaryngologist and speech pathologist evaluated all patients for the vocal functional issues during the follow-up. The relative data on time of placement of VP, time of use of PF, use of XRT, age, length of follow-up and interval of duration of each VP were recorded during the follow-up. Results: There was 87% of patients with primary TEP and 13% with secondary. The follow-up varied from 12 to 87 months, with average of 38 months for primary and 51 months for secondary TEP. There were 59% of patients submitted to XRT. The general rate of success was of 94%. In primary TEP it was of 97% and in the secondary, it was 78% (p=0.07) and after two years, the success rate was of 96% in primary TEP and 75% in secondary TEP (p=0.07). The use of XRT and patient age did not influence the success of use of VP among primary and secondary TEP, independently of length of follow-up. Conclusion: Tendency to greater success rate in Voice rehabilitation after TL with primary TEP was observed. Postoperative XRT and age did not influence success rate.
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Primary versus secondary tracheoesophageal puncture for speech rehabilitation in total laryngectomy: Long-term results with indwelling Voice Prosthesis
EUA, 2015Co-Authors: Carlos Takahiro Chone, Flavio M Gripp, Al Spina, An CrespoAbstract:OBJECTIVE: To evaluate the long-term use of indwelling Blom-Singer Voice Prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). The influence of the timing (primary or secondary) of tracheoesophageal puncture (TEP), use of radiotherapy (xRT), patient age, and length of follow-up were studied to evaluate the success rate of VP use. STUDY DESIGN AND SETTING: Prospective clinical study in a tertiary referral center. Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. All patients were evaluated for vocal functional issues by an otolaryngologist and a speech pathologist at I month, then at every 3 months up to I year, and then at every 6 months after 1 year of follow-up. The relative data on time of placement of VP, time of VP use, xRT, age, length of follow-up, and life span of each VP were recorded during the follow-up. RESULTS: Eighty-seven percent of the patients underwent primary and 13%, secondary TEP. The follow-up varied from 12 to 87 months, with an average of 38 months for primary and 51 months for secondary TEP. Fifty-nine percent of the patients were submitted to xRT. The general rate of success was 94%, with 97% for primary and 78% (P = 0.07) for secondary TEP; after 2 years, the success rate was 96% for primary and 75% for secondary (P = 0.07) TEP. The use of xRT and patient age had no influence on the success of VP use for primary and secondary TEP, independently of the length of follow-up. CONCLUSIONS: The success rate of Voice rehabilitation with VP was 94%. In primary TEP, the success rate was 97%, whereas in secondary TEP it was 78%; 2 years later, it was 96% and 75%, respectively. A tendency for a higher success rate in Voice rehabilitation after TL was observed in primary TEP. The use of xRT and age of patient had no influence on the success rate. (c) 2005 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. All rights reserved.1331899
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primary versus secondary tracheoesophageal puncture for speech rehabilitation in total laryngectomy long term results with indwelling Voice Prosthesis
Otolaryngology-Head and Neck Surgery, 2005Co-Authors: Carlos Takahiro Chone, Ana L Spina, Flavio M Gripp, Agricio Nubiato CrespoAbstract:OBJECTIVE: To evaluate the long-term use of indwelling Blom-Singer Voice Prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). The influence of the timing (primary or secondary) of tracheoesophageal puncture (TEP), use of radiotherapy (xRT), patient age, and length of follow-up were studied to evaluate the success rate of VP use. STUDY DESIGN AND SETTING: Prospective clinical study in a tertiary referral center. Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. All patients were evaluated for vocal functional issues by an otolaryngologist and a speech pathologist at 1 month, then at every 3 months up to 1 year, and then at every 6 months after 1 year of follow-up. The relative data on time of placement of VP, time of VP use, xRT, age, length of follow-up, and life span of each VP were recorded during the follow-up. RESULTS: Eighty-seven percent of the patients underwent primary and 13%, secondary TEP. The follow-up varied from 12 to 87 months, with an average of 38 months for primary and 51 months for secondary TEP. Fifty-nine percent of the patients were submitted to xRT. The general rate of success was 94%, with 97% for primary and 78% (P = 0.07) for secondary TEP; after 2 years, the success rate was 96% for primary and 75% for secondary (P = 0.07) TEP. The use of xRT and patient age had no influence on the success of VP use for primary and secondary TEP, independently of the length of follow-up. CONCLUSIONS: The success rate of Voice rehabilitation with VP was 94%. In primary TEP, the success rate was 97%, whereas in secondary TEP it was 78%; 2 years later, it was 96% and 75%, respectively. A tendency for a higher success rate in Voice rehabilitation after TL was observed in primary TEP. The use of xRT and age of patient had no influence on the success rate.
Matthew R Naunheim - One of the best experts on this subject based on the ideXlab platform.
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placement of a 16 french Voice Prosthesis at the time of secondary tracheoesophageal Voice restoration
American Journal of Otolaryngology, 2015Co-Authors: Matthew R Naunheim, Aaron K Remenschneider, Glenn Bunting, Daniel G DeschlerAbstract:Abstract Purpose Tracheoesophageal Voice restoration (TEVR) has traditionally been described with fistula tract creation, catheter placement, and Prosthesis placement. Prosthesis placement at the time of tracheoesophageal puncture (TEP) utilizing 20-French prostheses has been previously described. Smaller initial prostheses may allow fluent speech with reduced long-term complications, such as widening of the fistula and peri-Prosthesis leakage. This study evaluates the safety and efficacy of the 16-French prostheses placement at the time of secondary TEP. Methods All cases of 16-French tracheoesophageal Voice Prosthesis (TEVP) placement at the time of secondary TEP were reviewed from 1/2011 through 12/2013 at a large academic medical center. Perioperative complications attributable to device placement were recorded, including inability to place Prosthesis, intraoperative complications, post-operative infection, Prosthesis dislodgement, Prosthesis leakage, and inability to obtain Voice. Results Twenty-one patients received placement of a 16-French TEVP at the time of secondary TEP. All prostheses were placed without intraoperative complications. The proportion of patients who had minor complications within the first postoperative month was 23.8%, including leakage through the Prosthesis (3 of 21), granulation tissue near the Prosthesis (1 of 21), retained sheath (1 of 21) and Prosthesis displacement (1 of 21). Leakage and displacement were addressed with change and replacement, respectively. Fluent voicing was achieved in 85.7% patients, with a median time to voicing of 18.5 days. Conclusions Placement of 16-French TEVPs is effective and safe, with an acceptable rate of minor complications attributable to the Prosthesis. Therefore, a smaller Prosthesis may be primarily placed at the time of secondary TEP and is our preference.
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primary placement of a 16 french Voice Prosthesis at the time of tracheoesophageal Voice restoration
Otolaryngology-Head and Neck Surgery, 2014Co-Authors: Matthew R Naunheim, Aaron K Remenschneider, Glenn Bunting, Daniel G DeschlerAbstract:Objectives:Tracheoesophageal Voice restoration (TEVR) has traditionally been described with fistula tract creation, catheter placement, and secondary Prosthesis placement. Successful primary Prosthesis placement at the time of primary or secondary puncture using a 20 French Prosthesis has been previously described. We now wish to evaluate whether 16 French prostheses can be used safely and effectively.Methods:All cases of primary 16 French tracheoesophageal Voice Prosthesis (TEVP) placements at a large academic medical center were retrospectively reviewed from January 2011 through December 2013. Perioperative complications attributable to device placement were recorded. These included inability to place Prosthesis during procedure, intraoperative issues with primary placement, postoperative infection, Prosthesis dislodgement, leakage around/through the Prosthesis, or inability to obtain Voice.Results:Twenty-two patients received primary placement of a 16 French TEVP. All prostheses were successfully place...
Flavio M Gripp - One of the best experts on this subject based on the ideXlab platform.
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speech rehabilitation after total laryngectomy long term results with indwelling Voice Prosthesis blom singer
PubMed, 2015Co-Authors: Carlos Takahiro Chone, Ana L Spina, Agricio Nubiato Crespo, Flavio M GrippAbstract:Summary To evaluate long-term use of indwelling Blom-Singer Voice Prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). We studied the influence of time of performance of tracheo-esophageal puncture (TEP), use of radiotherapy (XRT), patients’ age and length of follow-up, on the rate of success of use of VP. Study Design: clinical prospective. Material and Method: Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. Both otolaryngologist and speech pathologist evaluated all patients for the vocal functional issues during the follow-up. The relative data on time of placement of VP, time of use of PF, use of XRT, age, length of follow-up and interval of duration of each VP were recorded during the follow-up. Results: There was 87% of patients with primary TEP and 13% with secondary. The follow-up varied from 12 to 87 months, with average of 38 months for primary and 51 months for secondary TEP. There were 59% of patients submitted to XRT. The general rate of success was of 94%. In primary TEP it was of 97% and in the secondary, it was 78% (p=0.07) and after two years, the success rate was of 96% in primary TEP and 75% in secondary TEP (p=0.07). The use of XRT and patient age did not influence the success of use of VP among primary and secondary TEP, independently of length of follow-up. Conclusion: Tendency to greater success rate in Voice rehabilitation after TL with primary TEP was observed. Postoperative XRT and age did not influence success rate.
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Primary versus secondary tracheoesophageal puncture for speech rehabilitation in total laryngectomy: Long-term results with indwelling Voice Prosthesis
EUA, 2015Co-Authors: Carlos Takahiro Chone, Flavio M Gripp, Al Spina, An CrespoAbstract:OBJECTIVE: To evaluate the long-term use of indwelling Blom-Singer Voice Prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). The influence of the timing (primary or secondary) of tracheoesophageal puncture (TEP), use of radiotherapy (xRT), patient age, and length of follow-up were studied to evaluate the success rate of VP use. STUDY DESIGN AND SETTING: Prospective clinical study in a tertiary referral center. Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. All patients were evaluated for vocal functional issues by an otolaryngologist and a speech pathologist at I month, then at every 3 months up to I year, and then at every 6 months after 1 year of follow-up. The relative data on time of placement of VP, time of VP use, xRT, age, length of follow-up, and life span of each VP were recorded during the follow-up. RESULTS: Eighty-seven percent of the patients underwent primary and 13%, secondary TEP. The follow-up varied from 12 to 87 months, with an average of 38 months for primary and 51 months for secondary TEP. Fifty-nine percent of the patients were submitted to xRT. The general rate of success was 94%, with 97% for primary and 78% (P = 0.07) for secondary TEP; after 2 years, the success rate was 96% for primary and 75% for secondary (P = 0.07) TEP. The use of xRT and patient age had no influence on the success of VP use for primary and secondary TEP, independently of the length of follow-up. CONCLUSIONS: The success rate of Voice rehabilitation with VP was 94%. In primary TEP, the success rate was 97%, whereas in secondary TEP it was 78%; 2 years later, it was 96% and 75%, respectively. A tendency for a higher success rate in Voice rehabilitation after TL was observed in primary TEP. The use of xRT and age of patient had no influence on the success rate. (c) 2005 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. All rights reserved.1331899
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primary versus secondary tracheoesophageal puncture for speech rehabilitation in total laryngectomy long term results with indwelling Voice Prosthesis
Otolaryngology-Head and Neck Surgery, 2005Co-Authors: Carlos Takahiro Chone, Ana L Spina, Flavio M Gripp, Agricio Nubiato CrespoAbstract:OBJECTIVE: To evaluate the long-term use of indwelling Blom-Singer Voice Prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). The influence of the timing (primary or secondary) of tracheoesophageal puncture (TEP), use of radiotherapy (xRT), patient age, and length of follow-up were studied to evaluate the success rate of VP use. STUDY DESIGN AND SETTING: Prospective clinical study in a tertiary referral center. Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. All patients were evaluated for vocal functional issues by an otolaryngologist and a speech pathologist at 1 month, then at every 3 months up to 1 year, and then at every 6 months after 1 year of follow-up. The relative data on time of placement of VP, time of VP use, xRT, age, length of follow-up, and life span of each VP were recorded during the follow-up. RESULTS: Eighty-seven percent of the patients underwent primary and 13%, secondary TEP. The follow-up varied from 12 to 87 months, with an average of 38 months for primary and 51 months for secondary TEP. Fifty-nine percent of the patients were submitted to xRT. The general rate of success was 94%, with 97% for primary and 78% (P = 0.07) for secondary TEP; after 2 years, the success rate was 96% for primary and 75% for secondary (P = 0.07) TEP. The use of xRT and patient age had no influence on the success of VP use for primary and secondary TEP, independently of the length of follow-up. CONCLUSIONS: The success rate of Voice rehabilitation with VP was 94%. In primary TEP, the success rate was 97%, whereas in secondary TEP it was 78%; 2 years later, it was 96% and 75%, respectively. A tendency for a higher success rate in Voice rehabilitation after TL was observed in primary TEP. The use of xRT and age of patient had no influence on the success rate.
