Submucosal purse-string suture as a treatment of leakage around the indwelling voice prosthesis.

Abstract

Leakage around the indwelling voice prosthesis is an annoying complication of tracheoesophageal speech. Twenty patients, who experienced peripheral leakage of the tracheoesophageal fistula, were treated with a purse-string suture. Our aim was to get the patients free of leakage without losing their voice prosthesis. The technique was considered successful if this objective was reached and unsuccessful if eventually closure of the fistula was required. Immediately after the procedure, no patients showed residual leakage. At 1 month, 2 patients experienced recurrent leakage. At a mean follow-up of 19.4 months, the method was successful in 16 patients and unsuccessful in 4 patients. If peripheral leakage is not amenable to simple downsizing of the indwelling voice prosthesis, we feel the purse-string suture is the first-choice treatment because of its safety, efficiency, low cost, and ease of application.