Surgical Closure Technique of Tracheoesphageal Fistulae

Yeung, Zenon; Fagan, Johan

Surgical Closure Technique of Tracheoesphageal Fistulae

Chapter in Book

2025-04-21

Journal Title

Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery

Publisher

University of Cape Town

Department

Division of Otorhinolaryngology

Faculty

Faculty of Health Sciences

License

http://creativecommons.org/licenses/by-nc/4.0/

Abstract

Tracheoesophageal fistula (TOF) speech is the optimal method for postlaryngectomy speech rehabilitation. Advantages include: •No external device required •Doesn’t rely on a battery •More natural, intelligible voice •Uses patient’s tidal volume ~500mL as energy, and therefore allows the patient to speak louder with a more sustained voice without any pauses However, problems do arise from time-to-time with the TOF and tracheoesophageal voice prosthesis: •Enlarging fistula around prosthesis causing leakage of saliva and food and aspiration pneumonia (Figure 4) •Leakage of saliva and food through the prosthesis •Granulations around the prosthesis •Failure of tracheoesophageal speech due to pharyngoesophageal segment spasm •Fungal colonisation of the prosthesis causing it to leak •Dislodgement and aspiration of the prosthesis into the tracheobronchial tree •Obstructed swallowing secondary to the prosthesis •Failure of tracheoesophageal speech because of lack of motivation and cost of the prostheses

Keywords

TOF, Tracheoesophageal Fistula, Closure, Surgery, Laryngectomy, Voice Prothesis

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