LONG-TERM FOLLOW-UP OF TRACHEOESOPHAGEAL PUNCTURE RESULTS

Since its introduction by Blom and Singer in 1980, tracheoesophageal p uncture with a voice prosthesis has become the most frequently recomme nded choice for speech rehabilitation of total laryngectomees. Many st udies have reviewed the initial speech acquisition success rates follo wing tracheoesophageal puncture; however, long-term follow-up in these initial successes has been lacking. In addition, factors predictive o f long-term success with tracheoesophageal speech have not been define d. Over a 10-year period, we retrospectively reviewed all total laryng ectomy patients, including those who have undergone primary or seconda ry tracheoesophageal puncture, at the University of Illinois Hospital and Clinics and the Westside Veterans Administration Hospitals. Surviv al in the total laryngectomy cohort of 202 patients ranged from 35% to 50%. Forty of these patients underwent tracheoesophageal puncture, in whom survival was 75%. Short-term success with tracheoesophageal spee ch was approximately 70% for our patients, while long-term success was achieved in 66%. Despite low socioeconomic status and relatively high alcoholism rates, successful maintenance of tracheoesophageal speech was achieved in the majority of cases. Tracheoesophageal speech should therefore be considered as a primary method of vocal rehabilitation i n all patients undergoing total laryngectomy.