Dewan Karuna, Erman Andrew, Long Jennifer L, Chhetri Dinesh K
Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Case Rep Otolaryngol. 2018 Sep 13;2018:9369602. doi: 10.1155/2018/9369602. eCollection 2018.
Tracheoesophageal prosthesis (TEP) is the most common voice restoration method following total laryngectomy. Prosthesis extrusion and aspiration occurs in 3.9% to 6.7% and causes dyspnea. Emergency centers are unfamiliar with management of the aspirated TEP. Prior studies report removal of aspirated TEP prostheses under general anesthesia. Laryngectomees commonly have poor pulmonary function, posing increased risks for complications of general anesthesia. We present a straightforward approach to three cases of aspirated TEP prosthesis removed in the ambulatory setting. In each case, aspirated TEP was diagnosed with flexible bronchoscopy under local anesthesia at the time of consultation, and all prostheses were retrieved atraumatically using a biopsy grasper forceps inserted via the side channel of the bronchoscope. The aspirated TEP prosthesis can be safely and efficiently removed via bedside bronchoscopy.
气管食管假体（TEP）是全喉切除术后最常见的语音恢复方法。假体脱出和误吸的发生率为3.9%至6.7%，并会导致呼吸困难。急诊中心对误吸TEP的处理并不熟悉。既往研究报道在全身麻醉下取出误吸的TEP假体。喉切除患者通常肺功能较差，全身麻醉并发症的风险增加。我们介绍一种在门诊环境中取出3例误吸TEP假体的简单方法。在每例病例中，会诊时在局部麻醉下通过可弯曲支气管镜诊断为误吸TEP，并且所有假体均通过经支气管镜侧孔插入的活检钳无创取出。误吸的TEP假体可通过床旁支气管镜安全有效地取出。
