Assessment of Factors Impacting Long-Term Utilization of Tracheoesophageal Speech Among Laryngectomees
| Autor: | Logan Harrold, James Kaiser Houghton, Shannon Kraft, James D. Garnett, Justin Bond, Christopher Boyd |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Laryngectomy Speech Esophageal Tracheoesophageal fistula Punctures 03 medical and health sciences Esophagus Postoperative Complications 0302 clinical medicine medicine Humans Complication rate Tracheoesophageal Speech 030223 otorhinolaryngology Aged Retrospective Studies Retrospective review business.industry General surgery General Medicine Middle Aged medicine.disease Term (time) Trachea Treatment Outcome Otorhinolaryngology 030220 oncology & carcinogenesis Abandonment (emotional) Female business Tracheoesophageal Puncture |
| Zdroj: | Annals of Otology, Rhinology & Laryngology. 130:802-809 |
| ISSN: | 1943-572X 0003-4894 |
| Popis: | Objective(s): To evaluate complication rate and abandonment rate after tracheoesophageal puncture and to assess factors associated with these outcome measures. Methods: Retrospective review of laryngectomy patients seen at a single academic institution between 1/1/2003 and 12/1/2018. Charts reviewed for demographics, medical comorbidities, tumor characteristics, surgical data, adjuvant treatment history, and complications related to laryngectomy or tracheoesophageal puncture. Complications were divided into minor and major. Results: A total of 293 laryngectomees met inclusion criteria. Of these, 69 patients (23.5%) underwent tracheoesophageal puncture. Average follow up was 64.6 months (SD 58.3). Overall laryngectomy complication rate was 43.3%. Overall tracheoesophageal puncture complication rate was 73.9%, with 39.1% of patients having major complications and 34.8% having minor complications only. Total abandonment rate for tracheoesophageal puncture was 34.8%. No associations were seen between tracheoesophageal puncture complication or abandonment rates based on age, gender, race, or insurance status. An increased rate of laryngectomy complications was seen after primary tracheoesophageal puncture (76.5% vs 41.3%, P = .005). Conclusion: Tracheoesophageal puncture outcomes were similar in patients with varied demographic, medical, and treatment backgrounds. When considering timing, our findings suggest that patients should be counseled on the possibility of increased complication risk after primary tracheoesophageal puncture. In those in whom the surgeon already has concerns about wound healing, it may be prudent to avoid primary tracheoesophageal puncture. The relatively high abandonment rate emphasizes the value of this measure of tracheoesophageal puncture outcome and highlights the need for appropriate patient counseling and prospective studies assessing the decision to abandon. |
| Databáze: | OpenAIRE |
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