Tracheoesophageal Puncture
Another option for restoring speech to the laryngectomy is the tracheoesophageal puncture or TEP. In this simple surgical procedure, a small puncture is made between the trachea and the esophagus, and a one-way air valve is inserted. This air supply can be used to cause vibrations in a similar manner to esophageal speech. This surgical procedure may occur during the laryngectomy (primary TEP) or after a period of time (secondary TEP).
The prosthesis is placed approximately 10–14 days post operation by a certified speech language pathologist (SLP) who specializes in ENT work. During the placement of a prosthesis, the SLP measures the depth of the puncture, chooses the correct prosthesis, and inserts it with a loading device (the entire process can occur in 30-45 minutes pending complications). Patients return to be resized every few months after surgery. When the puncture site stops changing sizes, then a more permanent prosthesis can be placed that will last approximately 6-12 months (indwelling prosthesis). Patients may choose this route, in which case they will return to the SLP for placement every 6-12 months, or may choose a low pressure, or duckbill prosthesis that they can change independently at home every few months. This option has become increasingly popular in the past 10 years, as in many cases intelligible voicing may be achieved within minutes of placement of the prosthesis. Some of the advantages to tracheoesophageal puncture are a higher success rate at about 95% of vocal rehabilitation and a much faster time frame compared to esophageal speech.(Pawar,Sayed, Kazi, Jagade,2008).
Read more about this topic: Esophageal Speech
Famous quotes containing the word puncture:
“And no one, it seemed, had had the presence of mind
To initiate proceedings or stop the wheel
From the number it was backing away from as it stopped:
It was performing prettily; the puncture stayed unseen....”
—John Ashbery (b. 1927)