Abstract
Background Enlargement of the tracheoesophageal puncture (TEP) is a challenging complication after laryngectomy with TEP. We sought to estimate the rate of enlarged puncture, associated pneumonia rates, potential risk factors, and conservative treatments excluding complete surgical TEP closure. Methods A systematic review was conducted (1978-2008). A summary risk estimate was calculated using a random-effects meta-analysis model. Results Twenty-seven peer-reviewed manuscripts were included. The rate of enlarged puncture and/or leakage around the prosthesis was reported in 23 articles (range, 1% to 29%; summary risk estimate, 7.2%; 95% confidence interval [CI], 4.8% to 9.6%). Temporary removal of the prosthesis and TEP-site injections were the most commonly reported conservative treatments. Prosthetic diameter (p =.076) and timing of TEP (p =.297) were analyzed as risk factors; however, radiotherapy variables were inconsistently reported. Conclusion The overall risk of enlarged puncture seems relatively low, but it remains a rehabilitative challenge. Future research should clearly establish risk factors for enlarged puncture and optimal conservative management.
Original language | English (US) |
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Pages (from-to) | 20-30 |
Number of pages | 11 |
Journal | Head and Neck |
Volume | 33 |
Issue number | 1 |
DOIs | |
State | Published - Jan 2011 |
Keywords
- complications
- enlarged tracheoesophageal puncture
- leakage
- total laryngectomy
- tracheoesophageal puncture
ASJC Scopus subject areas
- Otorhinolaryngology