Question: A 60 year old male undergoes total laryngectomy for advanced glottic carcinoma. His postoperative course is unremarkable and he eventually undergoes TEP placement. Roughly 6 months after prosthesis placement, he comes back to your office struggling to phonate. Exam reveals a loose prosthesis with red, raised tissue around the 3 o’clock position. This area is cauterized and the prosthesis is adjusted but he returns with the same issues and new bleeding. What is the next step?

a) Remove TEP and observe

b) Repeat cauterization

c) Interposition of tissue to close TEP

d) Biopsy

[Answer will be posted with next week's new question]

Answer to last week's question, “What Matters Most" (August 12, 2019)

B - Evidence of ongoing Eustachian tube dysfunction negatively impacts success rate.