Sayed Suhail, Chaukar Devendra, Chaturvedi Pankaj, Pai Prathamesh, Pantvaidya Gouri, Deshmukh Anuja, Nair Deepa, D'cruz Anil
Head & Neck Services, Tata Memorial Hospital, Mumbai, India.
Indian J Otolaryngol Head Neck Surg. 2013 Jan;65(1):71-5. doi: 10.1007/s12070-012-0607-5. Epub 2012 Dec 8.
Post laryngectomy voice rehabilitation using primary tracheoesophageal puncture (TEP) and voice prosthesis insertion is considered the "gold standard" method. No special effort is taken to measure the tracheoesophageal partywall thickness before inserting voice prosthesis. TE puncture related problems (peri-prosthetic leakage) are commonly seen in our population as compared to device failures (central leak). An accurate prosthesis inserted primarily may prevent the development of peri-prosthetic leakage. We surmise that tracheoesophageal party wall thickness (PWT) to be an important factor determining this phenomenon. There is still no consensus on the size of the prosthesis to be inserted during a primary TEP. To cater this, we propose a simple, quick and accurate method of measuring tracheoesophageal PWT intraoperatively. This method will guide us to determine an accurate prosthesis size which can be inserted during primary TEP. We also propose that this method will prevent future TE puncture related problems.
采用一期气管食管穿刺（TEP）及置入发音钮进行喉切除术后语音康复被认为是“金标准”方法。在插入发音钮之前，未采取特殊措施测量气管食管间隔壁厚度。与装置故障（中央渗漏）相比，TE穿刺相关问题（假体周围渗漏）在我们的患者群体中较为常见。一期准确置入假体可能会防止假体周围渗漏的发生。我们推测气管食管间隔壁厚度（PWT）是决定这一现象的重要因素。对于一期TEP期间置入假体的尺寸，目前仍未达成共识。为了解决这一问题，我们提出一种简单、快速且准确的术中测量气管食管PWT的方法。该方法将指导我们确定一期TEP期间可置入的准确假体尺寸。我们还提出，该方法将预防未来与TE穿刺相关的问题。
