Yoon Michelle, Joseph Justin, Ramirez Ricardo, Ganz Cindy, Smith Michael S, Urken Mark L
THANC (Thyroid, Head and Neck Cancer) Foundation, New York, New York, USA.
Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Head Neck. 2025 Mar;47(3):1062-1064. doi: 10.1002/hed.28068. Epub 2025 Jan 10.
Tracheoesophageal puncture (TEP) with voice prosthesis (VP) placement is commonly used to restore voice in laryngectomy patients. The conventional procedure utilizes a rigid esophagoscope to open and visualize the pharyngeal inlet. However, this approach is challenging in patients with postradiation changes, reduced neck extension, or trismus. Here, we demonstrate a modified technique involving flexible endoscopy and endotracheal tube placement to reestablish the TEP tract in a patient with a challenging anatomic profile. This step-by-step video demonstrates retrieval of a dislodged prosthesis and TEP/VP placement under general anesthesia, which results in effective voice restoration. This modified technique can safely and effectively restore voice in patients with difficult exposure.
带发音假体（VP）植入的气管食管穿刺（TEP）常用于恢复喉切除术后患者的发声功能。传统手术使用硬质食管镜打开并观察咽入口。然而，对于有放疗后改变、颈部伸展受限或牙关紧闭的患者，这种方法具有挑战性。在此，我们展示了一种改良技术，该技术涉及使用软性内镜和气管插管，以便在解剖结构复杂的患者中重建TEP通道。这段分步视频展示了在全身麻醉下取出移位的假体以及进行TEP/VP植入，从而实现有效的发声恢复。这种改良技术能够安全有效地为暴露困难的患者恢复发声功能。
