Speech rehabilitation and complications of primary tracheoesophageal puncture.

Fifty-nine patients underwent tracheoesophageal puncture during laryngectomy, and a voice prosthesis was inserted into the tracheoesophageal fistula to enable alaryngeal speech. For 68% of the 59 patients, tracheoesophageal speech was feasible right after surgery, and postoperative complications occurred in 9 of these 59. The results show that primary tracheoesophageal puncture is advantageous for alaryngeal speech rehabilitation. Eighty-two percent of the 22 patients who survived more than 4 years after surgery continued with tracheoesophageal speech, and 16 complications occurred over a longer term in 13 of the 22 patients. Since 75% of these long-term complications could be overcome by surgical treatment, close observation of the tracheoesophageal fistula and adequate treatment are needed for patients with tracheoesophageal speech and making use of a voice prosthesis.