**Author details**

Complications of tracheoesophageal puncture are complications resulting from the surgical procedure itself, and among them are tracheostoma of inadequate form, size and depth, inadequate tonus of the pharyngoesophageal segment (hypotonicity or hypertonicity) [38] and the

Complications of tracheoesophageal fistula occur in later postoperative period, most commonly the same patient having several different complications. Among these complications are the atrophy of the tracheoesophageal wall, tracheal mucosa granulation, esophageal mucosa hypertrophy, increase in diameter of tracheoesophageal fistulae, dislocation of the voice prosthesis and leakage of the esophagus from the voice prosthesis into the trachea [40]. Inadequate size of voice prosthesis causes pressure on the esophageal and tracheal mucosa and may result in fibromatous reactions [39]. Several cases of decubitus of the back esophageal wall have been reported due to the incompatibility of the length of the tracheoesophageal

The complications of the tracheoesophageal prosthesis are the release of one-way prosthesis valves, resulting in leakage of the esophagus through the voice prosthesis into the trachea [41, 42], and the creation of biofilm in the voice prosthesis due to its use during several months [43, 44].

The physiological function of the esophagus in healthy people is very simple: to actively transport solids and liquids from the pharynx to the stomach. It has no digestive, absorptive, metabolic, or endocrine functions, but in laryngectomized persons, esophagus takes one more function. In such changed anatomical condition, the esophagus has a key role in voice speech rehabilitation of laryngectomized patients because the esophageal and tracheoesophageal speech are the only acceptable solution of substitute alaryngeal speech. The esophagus gets very important function at alaryngeal phonation as air reservoir, the upper esophageal sphincter gets the function as air activator and the pharyngoesophageal segment gets the

function of the voice generator, thus allowing the function of the voice resonators.

We would like to thank Ms. Mirna Brunčić for translating this text.

The figures are from the author's own source.

The authors have no conflict of interest.

formation of pseudoepiglottis or pseudo-vallecula [39].

fistula with the length of the voice prosthesis.

**5. Conclusion**

78 Esophageal Cancer and Beyond

**Acknowledgements**

**Conflict of interest**

**Notes**

Ljiljana Širić<sup>1</sup> \*, Marinela Rosso2 and Aleksandar Včev<sup>3</sup>

\*Address all correspondence to: ljsiric@gmail.com

1 Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Centre Osijek, Osijek, Croatia

2 Polyclinic Rosso, Osijek, Croatia

3 Faculty of Medicine, J. J. Strossmayer University of Osijek, Osijek, Croatia
