Primary tracheoesophageal fistula procedure for voice restoration: The university of texas medical branch experience

Abstract

Abstract Voice restoration for laryngectomees is challenging, but in recent years the tracheoesophageal (TE) fistula procedure using a oneway valved prosthesis has had relatively good success. The purposes of this study were to determine the success rate for the primary TE fistula procedure, analyze failures, and study methods for selection and training of these patients. In a prospective study, 21 consecutive patients had primary TE fistula procedures performed over an 18‐month period. Thirteen of 20 who had adequate follow‐up developed fluent, intelligible speech using either duckbill or low‐pressure one‐way valves. Complications included one stomal infection and one paratracheal fistula. This experience has led 1. to development of a protocol for selection and training of patients for this procedure and 2. to the conclusion that the procedure can improve voice restoration success without an increase in morbidity.