Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy
Article first published online: 20 JUN 2011
Copyright © 2011 Wiley Periodicals, Inc.
Head & Neck
Volume 34, Issue 4, pages 557–567, April 2012
How to Cite
Hutcheson, K. A., Lewin, J. S., Sturgis, E. M. and Risser, J. (2012), Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy. Head Neck, 34: 557–567. doi: 10.1002/hed.21777
- Issue published online: 3 MAR 2012
- Article first published online: 20 JUN 2011
- Manuscript Accepted: 15 FEB 2011
- tracheoesophageal puncture;
- total laryngectomy;
- enlarged tracheoesophageal puncture;
- risk factors
Enlarged tracheoesophageal puncture (TEP) is a challenging complication of surgical prosthetic voice restoration. Prevention of this complication requires identification of high-risk individuals, and surgical and prosthetic correlates of TEP enlargement.
Multivariable logistic regression methods were used to analyze preoperative, perioperative, and postoperative risk factors for enlarged TEP in a 5-year retrospective cohort.
Enlarged TEP only occurred in irradiated patients. Adjusting for length of follow-up and timing of TEP, advanced (N2 or N3) nodal disease (odds ratio [OR]adjusted, 4.3; 95% confidence interval [CI], 1.0–19.1), postoperative stricture (ORadjusted, 3.2; 95% CI, 1.2–8.6), and diagnosis of locoregional recurrence or distant metastasis after laryngectomy (ORadjusted, 6.2; 95% CI, 2.3–16.4) increased risk of enlarged TEP. Extended resection and preoperative nutritional status were also significantly associated with enlarged TEP. Prosthetic parameters did not significantly correlate with enlargement.
Development of enlarged TEP is a multifactorial process related to both baseline and postoperative factors. © 2011 Wiley Periodicals, Inc. Head Neck, 2012