Tracheoesophageal Puncture - an Indian perspective

Neoplasms of the Larynx constitute a large group of malignancies in our country. The advanced stages of laryngeal carcinoma require a total laryngectomy, which is functionally and psychologically very debilitating for the patient, as he loses his speech. Although many methods have been devised to overcome this handicap, none has been proved to be entirely satisfactory. Singer and Blom (1980) introduced an endoscopic technique for voice restoration using a tracheoesophageal puncture. A one way silicone valve was used by them and they claimed a very high success rate. Similar good results were reported by other Western and Indian surgeons. However, in our series of ten patients, the results were not very encouraging. Sixty percent (6/10) patients could acquire speech but there were significant difficulties. We do not think that this technique should be used indiscriminately in a laryngectomee.