Tracheoesophageal puncture in the office setting with local anesthesia

Tracheoesophageal puncture (TEP with voice prosthesis placement is currentl y the method of choice for vocal rehabilitation of patients who have underg one total laryngectomy. Occasionally, secondary TEP needs to be performed. We have used a TEP technique that is performed in the clinic setting with l ocal anesthesia and no sedation, The purpose of this study was: to review o ur technique and experience and to evaluate results, complications, and pat ients' acceptance of the procedure. We performed a retrospective chart revi ew of the records of 14 patients who had undergone total laryngectomy and s econdary TEP placement in the clinic setting. The procedure was well tolera ted. The voice results were fair to good in 11 of 12 patients. There was 1 complication, a false passage between the trachea and the esophagus. Voicin g was immediate in 12 of the 14 cases. We conclude that TEP can be performe d in the office setting with local anesthesia. The voice results are excell ent, and the procedure is well tolerated by the patient. Proper patient sel ection and regular follow-up by a speech-language pathologist are important .