Primary and secondary tracheo-esophageal puncture: Long-term results with voice prosthesis

Abstract

Objectives: To evaluate the long-term use of indwelling Blom-Singer voice prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). There were studied the influence of the time (primary or secondary) of accomplishment of tracheo-esophageal puncture (TEP), use of radiotherapy (XRT), patient age and length of follow-up, on the rate of success of use of VP. Methods: Seventy-one patients submitted to TL and rehabilitated with indwelling VP were evaluated for vocal functional issues. The relative data on time of placement of VP, time of use of PF, use of XRT, age, length of follow-up and interval of duration of each VP were recorded. Results: There was 87% of patients with primary TEP and 13% with secondary. The follow-up varied from 12 to 87 months. There were 59% of patients submitted to XRT. The general rate of success was of 94%. In primary TEP, it was of 97% and in the secondary was 78% ( P = 0.07) and after 2 years, was of 96% in primary TEP and 75% in the secondary ( P = 0.07). Use of XRT and age did not influence in success of use of VP among primary and secondary TEP, independently of follow-up. Conclusions: The rate of success of voice rehabilitation with VP was of 94%. In primary TEP that rate was of 97% and of 78% in secondary TEP and after 2 years it was of 96% and 75%, respectively. Tendency to greater success rate in voice rehabilitation after TL with primary TEP was observed. XRT and age of patient did not influence in this rate of success.