New device for single-stage in-office secondary tracheoesophageal puncture: animal studies.

Abstract

A new device is described for secondary tracheoesophageal puncture (TEP). We hypothesize that the device can be used to create the puncture, size, and insert the voice prosthesis in antegrade fashion in a single procedure suitable for office-based use. A measurement and insertion device (MAID) was designed with the hypothesis in mind and tested on 3 pigs while they were under general anesthesia. The procedure was easy and successful in all 3 animals. The MAID allowed measurement of tracheoesophageal wall thickness and antegrade insertion of voice prosthesis with a single device. Transnasal esophagoscopy (TNE) allowed visualization of markings on the MAID within the esophagus to facilitate sizing. Intraesophageal visualization using TNE also enabled accurate positioning, reduced risk of posterior esophageal wall injury, and practically eliminated false passage formation. We believe the MAID can facilitate single-stage office-based secondary TEP in postlaryngectomy patients.