Influence of timing, radiation, and reconstruction on complications and speech outcomes with tracheoesophageal puncture.

Autor: Gitomer SA; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas., Hutcheson KA; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., Christianson BL; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., Samuelson MB; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., Barringer DA; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., Roberts DB; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., Hessel AC; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., Weber RS; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., Lewin JS; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., Zafereo ME; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2016 Dec; Vol. 38 (12), pp. 1765-1771. Date of Electronic Publication: 2016 Jul 09.
DOI: 10.1002/hed.24529
Abstrakt: Background: We evaluated the impact of radiation, reconstruction, and timing of tracheoesophageal puncture (TEP) on complications and speech outcomes.
Methods: Retrospective review identified 145 patients who underwent TEP between 2003 and 2007.
Results: Ninety-nine patients (68%) had primary and 46 (32%) had secondary TEP, with complications occurring in 65% and 61%, respectively (p = .96). Twenty-nine patients (20%) had major complications (18 primary and 11 secondary; p = .42). Ninety-four patients (65%) had pre-TEP radiation, 39 (27%) post-TEP radiation, and 12 (8%) no radiation. With patients grouped by TEP timing and radiation history, there was no difference in complications, fluency, or TEP use. With mean 4.7-year follow-up, 82% primary and 85% secondary used TEP for primary communication (p = .66). Free-flap patients used TEP more commonly for primary communication after secondary versus primary TEP (90% vs 50%; p = .02).
Conclusion: Primary and secondary tracheoesophageal speakers experience similar high rates of complications. Extent of pharyngeal reconstruction, rather than radiation, may be more important in selection of TEP timing. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1765-1771, 2016.
(© 2016 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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