New endoscopic secondary tracheoesophageal voice prosthesis placement technique.

Abstract

The aim of this study was to present a new technique of secondary vocal prosthesis placement on an outpatient basis without general anesthesia by means of digestive endoscopy. It is a prospective study, 35 laryngectomized patients were sedated with midazolam and underwent digestive endoscopy and tracheoesophageal punch with vocal prosthesis insertion. A success rate of 94.2% was achieved with this surgical technique. The mean procedure time was estimated at 12 minutes, and no serious complications due to the prosthesis insertion were observed. The advantages of this new technique over the classic technique are lack of use of general anesthesia, performance of procedure on an outpatient basis, lower complication risks (including hemorrhage, mediastinitis, vertebral fracture, esophageal perforation; and minor oropharyngeal, and esophageal mucosal trauma), and direct visualization of the prosthesis in the esophageal lumen.