{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:27:29Z","timestamp":1788535649823,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,7,9]],"date-time":"2016-07-09T00:00:00Z","timestamp":1468022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"MD Anderson Institutional Research Grant Program and the National Cancer Institute","award":["R03 CA188162"],"award-info":[{"award-number":["R03 CA188162"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We evaluated the impact of radiation, reconstruction, and timing of tracheoesophageal puncture (TEP) on complications and speech outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review identified 145 patients who underwent TEP between 2003 and 2007.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010nine patients (68%) had primary and 46 (32%) had secondary TEP, with complications occurring in 65% and 61%, respectively (<jats:italic>p<\/jats:italic> = .96). Twenty\u2010nine patients (20%) had major complications (18 primary and 11 secondary; <jats:italic>p<\/jats:italic> = .42). Ninety\u2010four patients (65%) had pre\u2010TEP radiation, 39 (27%) post\u2010TEP radiation, and 12 (8%) no radiation. With patients grouped by TEP timing and radiation history, there was no difference in complications, fluency, or TEP use. With mean 4.7\u2010year follow\u2010up, 82% primary and 85% secondary used TEP for primary communication (<jats:italic>p<\/jats:italic> = .66). Free\u2010flap patients used TEP more commonly for primary communication after secondary versus primary TEP (90% vs 50%; <jats:italic>p<\/jats:italic> = .02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Primary and secondary tracheoesophageal speakers experience similar high rates of complications. Extent of pharyngeal reconstruction, rather than radiation, may be more important in selection of TEP timing. \u00a9 2016 Wiley Periodicals, Inc. <jats:italic>Head Neck<\/jats:italic> <jats:bold>38:<\/jats:bold> 1765\u20131771, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.24529","type":"journal-article","created":{"date-parts":[[2016,7,9]],"date-time":"2016-07-09T14:07:03Z","timestamp":1468073223000},"page":"1765-1771","source":"Crossref","is-referenced-by-count":53,"title":["Influence of timing, radiation, and reconstruction on complications and speech outcomes with tracheoesophageal puncture"],"prefix":"10.1002","volume":"38","author":[{"given":"Sarah A.","family":"Gitomer","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas"},{"name":"Bobby R. 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