Surgical Treatment of Tracheostomal Stenosis

Giacomarra, Vittorio; Tirelli, Giancarlo; Bonini, Pierluigi

doi:10.1097/00005537-200107000-00026

Cited by 14 publications

(6 citation statements)

References 16 publications

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“…The technique we propose to correct stenosis of the external auditory canal has been transferred from the surgical procedure we have already described with regard to stenosis of the tracheostomy [19]. It varies in that fewer V-shaped flaps are used and part of the cartilage of the concha is removed.…”

Section: Discussionmentioning

confidence: 99%

Conchomeatoplasty: a new technique

Giacomarra¹,

Spinato

Bullo

et al. 2013

Eur Arch Otorhinolaryngol

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Stenosis of the cartilaginous auditory canal is still difficult to resolve and many techniques of plastic surgery have been proposed. Our experience was first built up in treatment of stenosis of the tracheostomy in patients who had undergone laryngectomy. Since it is simple and effective, we have transferred and modified the technique to the treatment of stenosis of the external auditory canal and of the concha. Fourteen patients with stenosis of the cartilaginous auditory canal (diameters of the stenosis prior to surgery varied from 19 to 78.5 mm(2)) underwent day-surgery conchomeatoplasty under local anaesthesia. Eight months after the operation, the results are good. Following surgery, the surface of the auditory canal, measured at the narrowest point of the external auditory meatus, varied from a minimum of 113 mm(2) to a maximum of 254 mm(2). The technique we propose to correct the stenosis of the external auditory canal is easy to carry out, short, and may be performed under local anaesthesia. Lastly, the auditory canal and the ear auricle have a good blood supply, thus ensuring the flaps will survive.

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Section: Discussionmentioning

confidence: 99%

Conchomeatoplasty: a new technique

Giacomarra¹,

Spinato

Bullo

et al. 2013

Eur Arch Otorhinolaryngol

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“…En cuanto a la revisión del estoma estenótico, debe garantizar la resección del tejido fibroso y de la cicatriz concéntrica, con una sutura sin tensión para evitar reestenosis. La plastia del estoma, dependiendo de si se trata de estenosis vertical, concéntrica o engrosamiento anterior (de acuerdo con la clasificación de Montgomery), comprende: la realización de Z-plastias, doble Z-plastia, creación de colgajos V-Y, colgajos en V, la resección periostomal del tejido fibrótico, las incisiones radiadas alrededor del estoma, el uso de colgajos en V en la piel combinados con la resección del borde traqueal anterior, incisiones en forma de esvástica alrededor del estoma estenótico con la creación de colgajos de rotación, la creación de colgajos de avance en forma de estrella con resección de piel, la técnica del "pétalo" que está basada en los colgajos de avance en forma de estrella (1,4,7,8,(13)(14)(15)(16).…”

Section: A B Discusiónunclassified

“…La estenosis del estoma traqueal es una complicación frecuente en el paciente laringectomizado, que puede aparecer en el posoperatorio inmediato o años más tarde. Aunque no hay un criterio objetivo para definirla, se considera que está presente cuando hay requerimiento del uso de cánula de traqueostomía por más de tres meses después de la laringectomía o la necesidad de plastia del estoma por alteración respiratoria durante el ejercicio o en reposo, o la dificultad para el aclaramiento traqueal (1,2). La estenosis compromete el flujo aéreo y el barrido mucociliar de secreciones traqueobronquiales, predisponiendo al paciente a infecciones recurrentes (2,3,4).…”

Section: Introductionunclassified

Plastia de estoma traqueal estenótico en un paciente laringectomizado

Namén

González

Guerrero³

2018

Acta otorrinolaringol cir cabeza cuello

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La estenosis del traqueostoma después de laringectomía es una complicación frecuente, con una incidencia entre 4-44%, que implica un reto terapéutico. Puede ocurrir en el posoperatorio temprano o tardío, como consecuencia de disección inadecuada de la piel y grasa periostomal al momento de la creación del estoma, tensión en la piel, dehiscencia de sutura y cierre por segunda intención, infección, cicatriz hipertrófica, radioterapia, uso de esteroides, entre otros. La estenosis estomal puede provocar disminución del flujo de aire, turbulencia e inhabilidad para aclarar secreciones; en todos los casos requiere revisión quirúrgica para aumentarel diámetro del traqueostoma, ya que el uso permanente de una cánula representa grandes desventajas para el paciente. Se han descrito múltiples técnicas de cirugía. Presentamos la técnica quirúrgica aplicada a un paciente con estenosis tardía del traqueostoma, que ha tenido resultados óptimos.

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“…Some of the cases suggest an occurrence of malignant growths in the region of permanent tracheostoma after laryngectomy which is usually considered to be the peristomal recurrence of the primary laryngeal carcinoma 6,7 . Various etiological factors have been indicated as the contributing factors to the onset of stenosis, including the type of skin incision, the diameter of trachea, excess skin and peristomal fat, incorrect mucosal -cutaneous suturing, hypertrophic scarring and keloid formation, radiotherapy, infection, and tracheoesophageal puncture [8][9][10][11] . Some potential cofactors can cause aberrant wound healing and play an important role in the genesis of TS such as adjuvant chemotherapy, advanced age, smoking, cardiopathies, diabetes, local infections, impaired immunocompetence, dan malnutrition 2 .…”

Section: Introductionmentioning

confidence: 99%

The Prevalence and Risk Factors of Tracheostomal Stenosis Following Total Laryngectomy

Muhtarum Yusuf,

Sofia Tiarini

2021

Indian Journal of Forensic Medicine & Toxicology

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Background: Tracheostomal stenosis (TS) following total laryngectomy is relatively common in patients and a distressing complication with major effects on patient rehabilitation it affected 4-44% of patients following total laryngectomy worldwide. Various etiological factors and some risks have been indicated as contributing to the onset of stenosis.Purpose: We aimed to investigate the prevalence and risk factors of tracheostomy stenosis following total laryngectomy Method: Tracheostomal stenosis was defined as respiratory insufficiency at rest or during exercise, difficulty in tracheal clearance due to non laminar flow, or both. Eighty data of patients were enrolled in this study consisting of 76 male (95.0%) and 4 females (5.0%). Baseline characteristics (BL) stage of cancer (SC), type of surgery (TS), the onset of stenosis following surgery (OS) and risk factors (RF) from each patient were recorded and analyzed using a pre-installed statistic software. Result:The overall prevalence of tracheostomal stenosis was 13.8% (11 of 80 patients). The prevalence and risk factors of tracheostomal stenosis following total laryngectomy consisted of 7 hypertrophic scar patients (63.3%), 2 infection patients (18.12), and 1 radiotherapy and peristomal fat patient (9.01), respectively. Conclusion:Out of eighty patients, eleven patients indicates the characters of tracheostomal stenosis using the bevel technique. The most common etiological factor is hypertrophic scar, followed by infection, radiotherapy and peristomal fat.

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Surgical Treatment of Tracheostomal Stenosis

Abstract: Early results suggest the routine use of this surgical technique in the treatment of stomal stenosis.

Cited by 14 publications

References 16 publications

Conchomeatoplasty: a new technique

Conchomeatoplasty: a new technique

Plastia de estoma traqueal estenótico en un paciente laringectomizado

The Prevalence and Risk Factors of Tracheostomal Stenosis Following Total Laryngectomy

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