Comparison between Primary and Secondary Tracheoesophageal Puncture Prosthesis: A Systematic Review

ORL J Otorhinolaryngol Relat Spec. 2017;79(4):222-229. doi: 10.1159/000477970. Epub 2017 Jul 29.


Introduction: Since the introduction of tracheoesophageal puncture (TEP) and placement of voice prosthesis, this has become the method of choice to achieve speech rehabilitation after total laryngectomy.

Objective: To compare the complications and success in speech rehabilitation of patients undergoing rehabilitation after primary and secondary TEP (TEP1 and TEP2) through a systematic review.

Methods: The literature survey included research in MedLine, Scielo, Lilacs, Cochrane and Websco until June 2016.

Results: The rate of leakage around the prosthesis was higher in TEP1 (22.5 vs. 6.9%, p = 0.03). There were higher rates of wound infection (9.1 vs. 3.9%) and tracheal stenosis (8.5 vs. 4.5%) in the TEP1 group compared to TEP2, however with no statistical significance. The evaluation of speech quality was not possible due to the heterogeneity of the studies.

Conclusion: There is a reduction in the risk of leakage around the prosthesis among TEP2 patients.

Keywords: Carcinoma; Complications; Laryngeal prosthesis; Laryngectomy; Meta-analysis; Rehabilitation; Squamous cell; Systematic review.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Esophagus / surgery
  • Humans
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / rehabilitation*
  • Larynx, Artificial*
  • Postoperative Complications
  • Prosthesis Failure
  • Prosthesis Implantation
  • Punctures
  • Trachea / surgery
  • Tracheal Stenosis / etiology
  • Tracheostomy / adverse effects