Tracheoesophageal fistula treatment
Following a laryngectomy for the treatment of laryngeal cancer, there are often wound healing problems (caused by subsequent radiotherapy, chemoradiotherapy and microbial growth) resulting in pharyngocutaneous and oesophagotracheal fistulas. In many cases, attempts are made to surgically close the fistula using flap techniques. But there are limitations to this as well.
The risk of aspiration makes swallowing and speaking impossible in patients with pharyngocutaneous and oesophagotracheal fistulas.
In these cases, epitheses, also known as tracheoesophageal fistula restorations, are fitted. To this end, an impression is taken at the clinic or a physical model is created using digital data sets.
This treatment restores functional swallowing of saliva and food (see video), as the materials used adapt to the anatomy and associated functions within the first 24 hours following the procedure. It is virtually impossible for the epithesis to dislocate and there are almost no leaks or fluid seepage. The loss of speech is a particularly significant problem for those affected.
Working closely with Dr. Steffen Dommerich from the Charité hospital in Berlin, we have been treating our patients with an integrated voice prosthesis (speech valves) for the past eight years to enable them to form sounds and speak – with amazing clinically confirmed results. The epithesis is usually changed every year.
Treating tracheoesophageal fistulas with integrated voice prostheses is an effective means of restoring swallowing function and achieves surprisingly good voice and speech rehabilitation outcomes.
Tracheoesophageal fistula treatment is performed both as an outpatient and inpatient procedure. The preparation and fitting rely on effective interdisciplinary collaboration between the ENT surgeon, anaesthetist and the medical engineer.
Primary treatment location:
Charité – Universitätsmedizin Berlin
Charité Mitte Campus
Clinic for Ear, Nose and Throat Medicine
Luisenstraße 13. 10117 Berlin
Director: Senior Consultant MD Steffen Dommerich