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At the recent southern sectional meeting of the Triological Society in Naples, Fla, Dr Tony Maniglia and coworkers, Cleveland, Ohio, reported on a retrospective analysis of 95 patients undergoing creation of tracheoesophageal fistulas for speech restoration after total laryngectomy. Thirty-three patients underwent creation of the tracheoesophageal fistula (primarily) at the time of initial surgery. The long-term success rate for speech development was 85% when the tracheoesophageal fistula creation was performed at the time of the initial procedure, as compared with 76% for the secondary tracheoesophageal fistula. Complication rates for primary and secondary procedures were 36% and 23%, respectively. Even though the data did not reflect a statistically significant difference, the authors demonstrated the effectiveness and safety of the creation of a tracheoesophageal fistula primarily, without severe complications and with long-term success rates.
FISHER SR. Speech Restoration and Complications of Primary vs Secondary Tracheoesophageal Function Following Total Laryngectomy. Arch Otolaryngol Head Neck Surg. 1989;115(8):906. doi:10.1001/archotol.1989.01860320016008
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