Tracheal advancement flap for postlaryngectomy stomal stenosis

Background Tracheal stenosis can be a troubling consequence of laryngectomy. Some revision techniques disturb the posterior stoma site of a current or planned tracheoesophageal puncture (TEP). Methods A revision technique which advances the trachea out of the stoma, divides the anterior tracheal wal...

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Bibliographic Details
Published in:Head & neck 1997-05, Vol.19 (3), p.211-215
Main Authors: Campbell, Bruce H., Rubach, Bryan W., McAuliffe, Timothy L., Freije, James E.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Carcinoma, Squamous Cell - surgery
Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics
Humans
Laryngeal Neoplasms - surgery
laryngectomy
Laryngectomy - adverse effects
Medical sciences
Reoperation
revision
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the upper aerodigestive tract
Surgical Flaps
Tracheal Stenosis - etiology
Tracheal Stenosis - surgery
tracheoesophageal puncture
tracheostenosis
tracheostoma
Treatment Outcome
Wound Healing - physiology
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Summary:Background Tracheal stenosis can be a troubling consequence of laryngectomy. Some revision techniques disturb the posterior stoma site of a current or planned tracheoesophageal puncture (TEP). Methods A revision technique which advances the trachea out of the stoma, divides the anterior tracheal wall, and leaves the posterior tracheal wall undisturbed was designed. The paper describes the technique in detail. “Success” was defined as producing a stable, trouble‐free stoma requiring no stenting; “partial success” as an improved stoma requiring some stenting; and “failure” as no improvement and continuous stenting. Results Fifteen patients underwent the procedure. Median time from laryngectomy to revision was 10 months. Preoperative to postoperative median stoma size increased from 63 mm2 to 135 mm2. Seven patients were classified as successful, six patients were partially successful, and two patients had no improvement. Conclusion The tracheal advancement flap is a safe technique for the laryngectomy patient who has undergone or might undergo voice restoration. © 1997 John Wiley & Sons, Inc. Head Neck 19: 211–215, 1997.
ISSN:1043-3074
1097-0347
DOI:10.1002/(SICI)1097-0347(199705)19:3<211::AID-HED8>3.0.CO;2-5