XXXX revision with simultaneous tracheoesophageal puncture.

@entity1 @entity850
OBJECTIVES/HYPOTHESIS: Vocal rehabilitation of @entity1 who have undergone laryngectomy is best accomplished by a tracheoesophageal puncture. Optimal function of the prosthesis requires an adequate stoma. @entity1 with @entity850 require revision of the stoma if vocal rehabilitation is to take place. Revision and tracheoesophageal placement are usually done as two separate procedures. Creating a tracheoesophageal fistula at the time of stomal revision has not been addressed in the literature. STUDY DESIGN: Prospective analysis and follow-up of 10 @entity1 undergoing simultaneous tracheoesophageal puncture and stomal revision for @entity850 between 1991 and 1996. METHODS: Ten @entity1 were reviewed. An inferiorly based V-Y advancement flap was used so as not to interfere with the tracheoesophageal puncture. All @entity1 had received radiation prior to revision and tracheoesophageal puncture. @entity1 were followed for a minimum of 2 years (range, 2-6 y; median, 3 y). RESULTS: All @entity1 maintained an adequate stoma without stenting. Eight of ten @entity1 (80%) developed and maintained good tracheoesophageal speech. Two @entity1 had their speech fistulas removed. There were no intraoperative or postoperative complications. CONCLUSIONS: Creation of a tracheoesophageal fistula at the time of stomal revision allows for vocal rehabilitation with a single visit to the operating room.
