A 13-Year Retrospective Study on Tracheoesophageal Prosthesis Outcomes From a Single Institution.

Abstract

Introduction: Tracheoesophageal voice prosthesis (TEP) is considered the gold standard among vocal rehabilitation methods. The evaluation of the clinical and epidemiological profile of patients rehabilitated with TEP is essential to describe the determining factors of rehabilitation with good functional results.

Objective: To describe the population of patients with total laryngectomy rehabilitated with TEP and to identify the variables associated with the outcome of vocal rehabilitation with TEP at the Brazilian National Cancer Institute (BNCI), between 2006 and 2019.

Method: Retrospective cohort study of patients with total laryngectomy enrolled in the Head and Neck Surgery Section of BNCI. Secondary data were collected through physical and electronic medical records, located through the database of patients undergoing vocal rehabilitation with TEP at BNCI from 2006 to 2019.

Results: A total of 165 patients with total laryngectomy were eligible for vocal rehabilitation with TEP. With 140 (84.8%) patients being male, 112 (67.9%) married and 112 (67.9%) with low education, 127 (77%) smokers and 126 (76.4%) heavy drinkers. Removal of the TEP occurred in 48 (29.1%) patients due to complications or the manifestation of a new tumor. And 157 (95.15%) patients were able to achieve phonation with TEP.

Conclusion: Older patients, with more advanced tumors, undergoing salvage laryngectomy or primary placement seem to be more likely to have complications and/or aphonia. Regular follow-up by a multidisciplinary team and consistent speech therapy with periodic assessments of the shunt/tract and voice prosthesis are crucial to preventing major complications and TEP removal.