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Evaluation of percutaneous tracheostomy (PT) with the guide wire dilating forceps (GWDF) technique. Prospective study of perioperative complications, retrospective analysis of early and late complications in an ICU in a teaching university hospital. The success rate of the procedure was 96.5%. The average procedure time in 171 consecutive patients was 5.0 min. Perioperative complications requiring surgical or medical intervention occurred in 6.4% of 171 patients. This included conversion to surgical tracheostomy, which was necessary in six patients (3.5%). Major complications while being cannulated occurred in 2.4% of 164 patients but seemed mostly unrelated with the GWDF technique itself. Late complications (after decannulation) were mostly minor and occurred in 22.6% of 106 patients. Only one patient (0.9%) had a symptomatic tracheal stenosis developed. Percutaneous tracheostomy with the guide wire dilating forceps technique is easy to perform at the bedside with few late complications. However, in our study, perioperative and immediate postoperative bleeding complications (minor and major) occur quite often. © 2002 Wiley Periodicals, Inc. Head Neck 24: 625–631, 2002

An anterior pharyngeal pouch is a common anatomic variation after total laryngectomy. The exact part the pouch has to play in postlaryngectomy swallowing disorders is unknown but might be bigger than expected. Nine patients with a symptomatic pouch were treated with CO2 laser and questioned about pre- and postoperative complaints. Eight out of nine patients noticed an obvious improvement of their swallowing complaints after laser surgery. Based on the results, it is concluded that CO2-laser treatment with division of the bar of tissue posterior to the pouch is seen as a safe and simple way to treat patients for symptoms that can be wrongly attributed to a total laryngectomy. © 1999 John Wiley & Sons, Inc. Head Neck 21: 310–314, 1999.

The Groningen, Nijdam and Provox voice prostheses (VP) are all low-pressure, indwelling voice prostheses. Although there are differences concerning the valve mechanism, they have a similar design and are therefore interchangeable. in a prospective study, 845 consecutive replacements were evaluated in 158 patients. Average device lifetime differed significantly from 13 weeks for the Provox VP and 15.8 weeks for the Groningen VP, to 19 weeks for the Nijdam device. Leakage through or around a voice prosthesis was the main replacement indication. Leakage occurred significantly more often with the Provox VP (80.2%) than with the Groningen VP (58.8%) or the Nijdam VP (55%). Increased airflow resistance as a replacement indication occurred significantly more often with the Groningen VP (45.4%) and the Nijdam VP (45.9%) than with the Provox VP (22.7%). Complications during the replacement procedure were rare and usually mild. Replacement was usually an easy outpatient procedure; general anaesthesia was only necessary in 3.0% of 845 replacements, without any significant difference between the three devices. Granulation tissue and hypertrophic scar tissue formation were the most frequent local complications. They occurred in less than 10% of our patients but were significantly more common in patients with a Nijdam VP.