Publication Type:

Journal Article


Head and Neck, Volume 35, Number 2, p.E60-E63 (2013)



aged, article, Artificial, clinical article, Deltoid Muscle, deltopectoral flap, donor site, esophagus, esophagus speech, female, Follow-Up Studies, human, Humans, Laryngeal Neoplasms, laryngectomy, Larynx, male, middle aged, nose feeding, Pectoralis Muscles, postoperative period, priority journal, Prosthesis Failure, Prosthesis Implantation, puncture, Punctures, Retrospective Studies, Sampling Studies, Surgical Flaps, surgical infection, surgical technique, Trachea, tracheoesophageal fistula, tracheoesophageal puncture site closure, tracheostomy tube, treatment outcome, voice prosthesis, wound dehiscence


Background Tracheoesophageal puncture (TEP) combined with a voice prosthesis is commonly used for voice production in postlaryngectomy patients. In certain cases, however, leakage occurs around the prosthesis. Many techniques have been described to correct this problem. Surgical closure of the puncture site has to be done if the conservative techniques fail. We present the use of the pedicled deltopectoral flap on the basis of a single perforator in the closure of these fistulae. Methods The reported technique was used in 6 patients over a period 8 years from 2004 to 2011. Results The technique was successful in 5 patients. In 1 case there was dehiscence at the leading edge of the flap because of severe local wound infection. Conclusion The novel technique described by us avoids the need for layered closure or dissection of the trachea and esophagus. It is simple and reliable and provides durable results. © 2011 Wiley Periodicals, Inc.


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Cite this Research Publication

D. Balasubramanian, Iyer, S., and Thankappan, K., “Tracheoesophageal puncture site closure with single perforator-based deltopectoral flap”, Head and Neck, vol. 35, pp. E60-E63, 2013.