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Research Letter
April 2018

Injectable Soft-Tissue Augmentation for the Treatment of Tracheoesophageal Puncture Enlargement

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, University of California at Irvine, Orange
  • 2Department of Otolaryngology–Head & Neck Surgery, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston
JAMA Otolaryngol Head Neck Surg. 2018;144(4):383-384. doi:10.1001/jamaoto.2017.3422

Tracheoesophageal voice restoration is currently the preferred surgical method for alaryngeal speech production. While it is a safe procedure with a high success rate, minor adverse consequences have been described, including enlargement of the tract around the tracheoesophageal prosthesis (TEP).1 This can result in periprosthetic leakage, which has been shown to increase the risk of pneumonia, voice prosthesis enlargement, and aspiration of the prosthesis.2 Frequently, a combination of nonsurgical and surgical strategies are used to effectively address this. Tissue augmentation around the tract has been described using a variety of injectable substances with varying degrees of success.1,3 The objective of this study was to determine the effectiveness of injectable augmentation with either nonresorbable calcium hydroxyapatite (CaHA) or resorbable hyaluronic acid (HA) in the treatment of TEP puncture site enlargement after total laryngectomy.