At the 4th International Conference of Head and Neck Cancer held
in Toronto, Canada, Robert H. Maisel, md, an otolaryngologist
at the University of Minnesota Cancer Center, advocated performing
tracheoesophageal puncture (TEP) at the time of surgical removal
of the voice box due to cancer. While the voice-rehabilitating
surgical procedure has been part of the cancer operation since
1985, it has traditionally been performed several months after
removal of the larynx.
"The primary TEP (done at time of cancer surgery) should
be strongly considered in all laryngectomy patients. Complications
have been minimal and the potential benefits in rehabilitating
the patient immediately are very high," says Maisel. These
benefits include talking within 2 weeks of the surgery and eliminating
the need for uncomfortable nasal feeding tubes, as well as obviating
the need for a second surgery.
Tracheoesophageal puncture enables air to travel from the lung
to the mouth and vibrate off the esophagus, allowing the person
to make sounds. Approximately 50% of patients undergoing TEP can
resume speaking without requiring an artificial voice box or electrolarynx.
Although it cannot completely restore voice quality, TEP provides
a more natural-sounding voice than does the electrolarynx. Approximately
5,000 people a year in the United States undergo laryngectomies
due to cancer.