Alkathine shell, an innovative way of neck flexion after tracheoplasty

Tracheal resection and end-to-end anastomosis is the treatment of choice for mature, isolated, segmental tracheal stenosis and tracheomalacia. Postoperatively, it is important to avoid tension at the anastomotic site. This is usually done by keeping the head in flexion, by a skin suture from chin to chest in the midline. Movement in the post-operative period often results in cutting through of this suture and also formation of scar tissue at the suture site, particularly in those prone to keloid formation. We report seven cases with tracheal stenosis who had primary repair and were managed postoperatively without the midline chin to chest suture, but with an alkathine shell, to maintain the neck in flexion for ten days postoperatively. This had good results with minimal complications.