Surgery of persisting tracheo-esophageal provox-fistula]

Voice rehabilitation after laryngectomy by tracheo-esophageal puncture with insertion of voice prosthesis (provox, bloom singer) has proven a valuable tool for many years. However, in some patients major problems arise due to enlarged tracheo-esophageal fistulas causing troublesome aspiration. Many different approaches for closure of these fistulas have been suggested including major surgery like myocutaneous flaps. In the paper we describe our safe and reliable procedure of a three layered closure of tracheao-esophageal fistulas using a sliding trachea as the third layer.