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LOUIS A. MODICA, MD
Johnson City, Tenn

Arch Otolaryngol Head Neck Surg. 1989;115(5):633.

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In Reply.—I appreciate Singer's comments and respectfully acknowledge his pioneering efforts and continuing leadership in this area.

I was mistaken to include hematoma and esophageal reflux in my table of complications of tracheoesophageal puncture for vocal restoration without a footnote indicating that these are actually complications of the adjunctive procedure of cricopharyngeal myotomy. It was not my intention to misrepresent the findings of Singer's article, and I apologize to him.

It is not clear why Singer denies cervical spine fracture and esophageal perforation as complications of the puncture procedure. Both complications are reported by others as a consequence of this procedure, without concurrent myotomy.^1,2

My experience shows that if examined carefully in the early postoperative period, the majority of my patients are found to have minor leakage of saliva, with aspiration, which is evidenced by direct inspection and cough. Generally, this resolves in about 1 week and is . . . [Full Text PDF of this Article]

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