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Updated: Jul 15, 2026
10:06
Manufacture of a Multi-Purpose Low-Cost Animal Bench-Model for Teaching Tracheostomy
Published on: May 18, 2019
An approach to complex tracheostomal complications
1Department of Plastic, Hand and Reconstructive Surgery, St James's Hospital, Beckett Street, Leeds LS9 7TF, UK. dr.chris.baldwin@btinternet.com
Summary
Complex fistulae after laryngectomy can be challenging. A new single-stage surgical approach involves debridement, primary suture with tissue transfer, and potential tracheostome repositioning for effective fistula repair and future voice rehabilitation.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Plastic Surgery
Background:
- Pharyngocutaneous fistulae are common post-laryngectomy complications (5-30%).
- Tracheoesophageal fistulae are rare, often linked to surgical speech fistulae or tumor recurrence.
- Complex post-laryngectomy fistulae present significant management challenges.
Observation:
- Presents five cases of complex post-laryngectomy fistulae.
- Details a novel surgical management strategy for these complex cases.
Findings:
- Advocates debridement of necrotic tissue and primary suture of defects.
- Utilizes healthy, viable tissue transfer for interposition.
- Describes tracheal mobilization and tracheostome repositioning outside radiotherapy fields if necessary, including manubrium and hemi-clavicle excision.
Implications:
- Enables single-stage reconstruction for complex fistulae.
- Preserves the option for future tracheoesophageal fistula creation for voice rehabilitation.
- Offers a potentially improved management pathway for challenging post-laryngectomy complications.
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