Division of Otorhinolaryngology, Department of Neurosurgery and ENT Diseases, Medical University "Prof. Dr. P. Stoyanov", 55, Marin Drinov Str., 9002, Varna, Bulgaria.
Department of Otolaryngology, MBAL Plovdiv Hospital, Plovdiv, Bulgaria.
J Otolaryngol Head Neck Surg. 2022 Jun 6;51(1):24. doi: 10.1186/s40463-022-00571-z.
Tracheoesophageal puncture (TEP) with use of a prosthesis is nowadays a standard for voice restoration after laryngectomy. Different TEP approaches exist.
We retrospectively reviewed our series of patients who underwent TEP by a novel technique, based partially on the Lichtenberger endo-extralaryngeal needle carrier. The instrument is covered with a protective Nelaton catheter and introduced via the mouth to the neopharynx/esophagus. No rigid endoscope is used for visualization of the TEP site. The tip is palpated through the stoma at the posterior tracheal wall and incision is done to the catheter tip. The prosthesis is introduced through the mouth and the neopharynx in a retrograde fashion.
In 14 laryngectomees with postoperative radiation voice prosthesis was successfully placed with this technique. A total of 18 procedures were performed. One misplacement occurred. No other early or late complications were observed or any other TEP or prosthesis related problems.
The rationale of our technique is to simplify the procedure, avoid risk-bearing approaches and instruments such as rigid endoscopes, simplify the armamentarium and reduce tissue trauma. The initial clinical experience in 18 TEPs confirmed it usefulness in both standard and anatomically challenging situations.
The current study obtained the ethical approval from the Faculty of Medicine at Medical University "Prof. Dr. Paraskev Stoyanov"-Varna, Bulgaria (Protocol 087/24.10.2019 (retrospectively registered).
经气管食管穿刺（TEP）并用假体，如今已成为喉切除术后恢复语音的标准方法。目前存在多种 TEP 方法。
我们回顾性分析了采用一种新的技术行 TEP 的患者系列，该技术部分基于 Lichtenberger 经内喉外针携带器。该器械被保护性的 Nelaton 导管覆盖，并经口引入到新咽部/食管。TEP 部位的可视化不使用刚性内窥镜。尖端通过气管后壁造口触诊，并在导管尖端进行切割。假体通过口腔和新咽部逆行引入。
在 14 例接受术后放疗的喉切除患者中，成功地采用该技术放置了语音假体。共进行了 18 次手术。有一次出现了错位。没有观察到其他早期或晚期并发症，也没有其他 TEP 或假体相关问题。
我们技术的原理是简化手术过程，避免使用有风险的器械，如刚性内窥镜，简化器械并减少组织创伤。在 18 例 TEP 中的初步临床经验证实了它在标准和解剖上具有挑战性的情况下都有用。
本研究获得了保加利亚瓦尔纳“普罗夫迪夫教授博士帕拉斯凯夫·斯多扬诺夫”医科大学医学系的伦理批准（方案 087/24.10.2019（回顾性注册）。
