CPT® Code 31611

Construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis (eg, voice button, Blom-Singer prosthesis)

The procedure described by CPT® Code 31611 involves the construction of a tracheoesophageal (TE) fistula, which is a surgical connection created between the trachea and the esophagus. This procedure is particularly relevant for patients who have undergone a laryngectomy, a surgical removal of the larynx, which typically results in the loss of the ability to produce normal speech. The TE fistula allows for the insertion of an alaryngeal speech prosthesis, commonly referred to as a voice button or Blom-Singer prosthesis. This device enables patients to produce speech by redirecting airflow from the lungs into the esophagus, where it vibrates the esophageal tissue to create sound. The procedure is performed using a rigid bronchoscope, which is inserted into the pharynx to provide visualization and facilitate the surgical steps. The creation of the fistula involves puncturing the posterior wall of the trachea and the anterior wall of the esophagus, forming a tract that connects the two structures. Following the creation of the fistula, a catheter is inserted to maintain the tract's patency, and the fistula is allowed to mature for about one week before the prosthesis is inserted. In some cases, this procedure can be performed concurrently with the laryngectomy under direct visualization, streamlining the surgical process for the patient.