How I do it: modified lichtenberger-brown tracheoesophageal puncture procedure

Abstract Background Tracheoesophageal puncture (TEP) with use of a prosthesis is nowadays a standard for voice restoration after laryngectomy. Different TEP approaches exist. Methods We retrospectively reviewed our series of patients who underwent TEP by a novel technique, based partially on the Lic...

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Main Authors: Nikolay R. Sapundzhiev, Asen G. Asenov, Blagovesta Spasova, Petya S. Genova, Georgi I. Davidov, Darina Ivanova
Format: Article
Language:English
Published: SAGE Publishing 2022-06-01
Series:Journal of Otolaryngology - Head and Neck Surgery
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Online Access:https://doi.org/10.1186/s40463-022-00571-z
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author Nikolay R. Sapundzhiev
Asen G. Asenov
Blagovesta Spasova
Petya S. Genova
Georgi I. Davidov
Darina Ivanova
author_facet Nikolay R. Sapundzhiev
Asen G. Asenov
Blagovesta Spasova
Petya S. Genova
Georgi I. Davidov
Darina Ivanova
author_sort Nikolay R. Sapundzhiev
collection DOAJ
description Abstract Background Tracheoesophageal puncture (TEP) with use of a prosthesis is nowadays a standard for voice restoration after laryngectomy. Different TEP approaches exist. Methods 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. Results 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. Conclusions 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. Trial registration 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). Graphical abstract
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spelling doaj-art-aeb2ffe61d48477a9da4c2d098ba9c002025-01-02T04:59:13ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162022-06-015111610.1186/s40463-022-00571-zHow I do it: modified lichtenberger-brown tracheoesophageal puncture procedureNikolay R. Sapundzhiev0Asen G. Asenov1Blagovesta Spasova2Petya S. Genova3Georgi I. Davidov4Darina Ivanova5Division of Otorhinolaryngology, Department of Neurosurgery and ENT Diseases, Medical University “Prof. Dr. P. Stoyanov”Department of Otolaryngology, MBAL Plovdiv HospitalDivision of Otorhinolaryngology, Department of Neurosurgery and ENT Diseases, Medical University “Prof. Dr. P. Stoyanov”Division of Otorhinolaryngology, Department of Neurosurgery and ENT Diseases, Medical University “Prof. Dr. P. Stoyanov”Division of Otorhinolaryngology, Department of Neurosurgery and ENT Diseases, Medical University “Prof. Dr. P. Stoyanov”Department of Diagnostic Imaging and Radiotherapy, Medical University “Prof. Dr. P. Stoyanov”Abstract Background Tracheoesophageal puncture (TEP) with use of a prosthesis is nowadays a standard for voice restoration after laryngectomy. Different TEP approaches exist. Methods 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. Results 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. Conclusions 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. Trial registration 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). Graphical abstracthttps://doi.org/10.1186/s40463-022-00571-zLaryngectomyAlaryngeal speechTracheoesophageal puncture
spellingShingle Nikolay R. Sapundzhiev
Asen G. Asenov
Blagovesta Spasova
Petya S. Genova
Georgi I. Davidov
Darina Ivanova
How I do it: modified lichtenberger-brown tracheoesophageal puncture procedure
Journal of Otolaryngology - Head and Neck Surgery
Laryngectomy
Alaryngeal speech
Tracheoesophageal puncture
title How I do it: modified lichtenberger-brown tracheoesophageal puncture procedure
title_full How I do it: modified lichtenberger-brown tracheoesophageal puncture procedure
title_fullStr How I do it: modified lichtenberger-brown tracheoesophageal puncture procedure
title_full_unstemmed How I do it: modified lichtenberger-brown tracheoesophageal puncture procedure
title_short How I do it: modified lichtenberger-brown tracheoesophageal puncture procedure
title_sort how i do it modified lichtenberger brown tracheoesophageal puncture procedure
topic Laryngectomy
Alaryngeal speech
Tracheoesophageal puncture
url https://doi.org/10.1186/s40463-022-00571-z
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