Department of Otorhinolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.
Head Neck. 2012 May;34(5):717-20. doi: 10.1002/hed.21807. Epub 2011 Jul 7.
The purpose of this study was to show a novel technique for secondary tracheoesophageal puncture (TEP) and myotomy in patients who previously underwent total laryngectomy.
Fifteen patients underwent secondary TEP and 3 patients underwent myotomy. In 1 patient, both myotomy and TEP were done concurrently. A Foley catheter is nasally inserted into the esophagus with the patient under local anesthesia and the catheter balloon is inflated at the site of the planned procedure. The myotomy is performed over the inflated balloon for esophageal posterior wall protection and a voice prosthesis is inserted in a small incision made by the physician. When only myotomy is performed, the muscles over the mucosa are incised. A voice test is performed immediately.
All patients exhibited good voice rehabilitation. One patient who had a myotomy had a penetration of the pharyngeal mucosa with immediate closure and no sequelae.
Outpatient Foley catheter-guided myotomy and secondary TEP are simple, safe, time saving, and cost-effective procedures.
本研究旨在展示一种针对既往行全喉切除术患者进行二次气管食管造瘘术（TEP）和肌切开术的新方法。
15 例患者接受了二次 TEP，3 例患者接受了肌切开术。在 1 例患者中，同时进行了肌切开术和 TEP。在局部麻醉下，将 Foley 导管经鼻腔插入食管，在计划手术部位充气气囊。在充气气囊上进行肌切开术，以保护食管后壁，并由医生在小切口插入语音假体。仅进行肌切开术时，切开黏膜上的肌肉。立即进行语音测试。
所有患者均表现出良好的语音康复效果。1 例肌切开术患者出现咽黏膜穿孔，立即闭合，无后遗症。
门诊 Foley 导管引导下肌切开术和二次 TEP 是简单、安全、省时和具有成本效益的操作。
