Tracheal Stoma Reconstruction

Tracheostomal stenosis revision with simultaneous tracheoesophageal puncture

“…When performed by itself the success of tracheostomal reconstruction approaches 70% after a single procedure. This increases to 90% after multiple procedures 19,24,25 . In our series the success rate of the stomal revision as judged by the lack of a need to wear a stent or tube was 100%.…”

“…The incidence of tracheostomal stenosis after total laryngectomy varies depending on the criteria used to define it 17,19,20 . Anyone who requires a stent in his or her tracheal stoma for longer than 3 months following surgery is commonly considered to have tracheostomal stenosis 20 .…”

Management of Tracheostomal Stenosis

“…Most of these reports encompassed few patients with few long‐term results. What is more prevalent is the method by which the authors have described their primary technique of stomal reconstruction at the time of laryngectomy 5,6,12,14 . These techniques are applicable during the time of the tracheostomal revision.…”

“…Insertion of a triangular piece of skin may lead to a substantial increase in tracheoesophageal wall thickness. This may preclude use of a tracheoesophageal puncture 5 . When reconstruction is required, it must consist of a total stomal reconstruction, not just a minor adjustment.…”

“…Successful surgical revision allows for stent removal and vocal rehabilitation with a tracheoesophageal puncture 3 . Several stomal revision techniques have been described 4‐12 . Most reports deal with a single treatment modality by a single individual.…”