[Studies on treacheostomal formation and voice prosthesis after total laryngectomy]

To establish a tracheostomy model with no stricture and "bowl-shaped" collapse.

Twenty-five cases were reconstructed with Blom-Singer technique after total laryngectomy for tracheoesophageal voice in our department since 1996. Tracheostoma was done with 5 kinds of methods. In 6 cases, anterior cervical U-shaped incision + division of sternal attachments of bilateral sternomastoid muscles + Griffith tracheostoma enlargement (combination method) were used in the primary operation, and the third generation of indwelling prosthesis and tracheostomal valve were installed.

In these 25 cases, 23 could speak freely. The successful rate was 92%. In tracheostoma operation, there were 7 cases with their skin sutured directly to tracheal rings, 3 cases with Myers method, 6 cases with Griffith method, 3 cases with [symbol: see text] method. All of them needed cannulation for more than 6 months and had stricture of tracheostoma and "bowl-shaped" collapse of various degrees. But those underwent "combination method" needed no cannulation and no stricture and bowlshaped collapse was found during 6 mouths' follow-up.

The combination method of tracheostomy makes the installation, postoperative care and replacement of prosthesis and tracheostomal valve easy and the indwelling prosthesis has the best tone quality. The use of tracheostomal valve effectively makes the patient's hand free during speaking.