Background:
Restoring voice post laryngectomy involves creation of a tracheoesophageal puncture (TEP) either at the time of surgery, termed primary TEP, or at a later date, known as secondary TEP. Wait times for secondary TEP can be 6-12months in our centre. To reduce wait times and avoid an overnight admission and GA, the departments of ENT and SLT developed an in-office protocol for performing secondary TEP.
Methods:
The patient records of those awaiting secondary TEP were reviewed by ENT & SLT. Suitable patients received education on the in-office awake procedure and aftercare associated with maintaining a voice prosthesis (VP). Those who consented were scheduled for the procedure.
Results:
Of ten patients awaiting secondary TEP, 50% (n=5) were suitable for the in-office procedure. All patients were male, aged between 61-79yrs. Average length of waiting time was 7.75months. There was an 80% success rate with one patient unsafe to proceed. 50% (n=2) patients were successfully fitted with a VP with immediate voicing achieved. Approximately €9000 was saved by the procedure being performed in a clinic setting.
Conclusion:
This interprofessional collaborative initiative, the first of its kind in Ireland, has allowed life-changing services to be made accessible for the right patients.