UICC World Cancer Congress 2006

Objective: Primary TEP is a procedure of choice in patients undergoing total laryngectomy. Recurrent expenditure limits its use in a developing country like India. Tata Memorial Hospital is the largest tertiary cancer centre in South Asia. Primary TEP is commonly performed at our hospital. A prospective database is maintained to find out the feasibility and effectiveness of this procedure in developing country.

Methods: This is an ongoing prospective study of primary TEP from June 2003 till date. All patients were evaluated for voice quality by trained speech pathologist and objectively by Doctor Speech Software to determine the acoustic characteristics of voice. TEP related parameters like percentage of patients speaking, and TEP related complications like, leakage through & around TEP and TEP displacement were recorded. TEP life span and reinsertion rate were calculated. These parameters were correlated with site of disease, extent of resection, type of closure, pharyngeal myotomy, neurectomy, radiotherapy and pharyngo-cutaneous fistula.

Results: From June 2003 till Nov 2005 (30 months) 130 patients underwent 157 TEP insertions. 91% patients are speaking with mean frequency 123 Hz and MPT 6.9 seconds. 5% patients had displacement. 12.7% patients had Through TEP leakage whereas 9.2% had around TEP leakage. 21 patients required 27 changes of prosthesis. Median TEP life span was 568 days. At the end of 1 year only 20.8% required a change of prosthesis. A good success rate and a prolonged TEP life span makes this procedure feasible and cost effective.