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Related Concept Videos

Tracheostomy Decannulation01:21

Tracheostomy Decannulation

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Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
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Tracheostomy Suctioning II: Procedure01:23

Tracheostomy Suctioning II: Procedure

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Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting...
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Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

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A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
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Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

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A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
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Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

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Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
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Related Experiment Video

Updated: Feb 17, 2026

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

Published on: October 24, 2025

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Reconstruction after salvage laryngectomy.

David H Yeh1, Axel Sahovaler1, Kevin Fung1

  • 1Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.

Oral Oncology
|December 12, 2017
PubMed
Summary

Salvage total laryngectomy after radiation therapy can lead to complications. Vascularized tissue reconstruction significantly reduces pharyngocutaneous fistula risk and improves outcomes for laryngeal cancer patients.

Keywords:
Free flapsHead and neck cancerHead and neck reconstructionLaryngeal cancerLaryngectomyReconstructive surgerySalvage therapy

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Learning Modern Laryngeal Surgery in a Dissection Laboratory
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Area of Science:

  • Otolaryngology
  • Surgical Oncology
  • Radiation Oncology

Background:

  • Organ-preserving strategies for laryngeal cancer, including radiation and chemoradiotherapy, are effective but can result in residual/recurrent disease or laryngeal dysfunction.
  • Salvage total laryngectomy is the treatment for persistent or recurrent laryngeal cancer post-radiation.
  • Radiotherapy and chemotherapy create challenging surgical conditions for salvage laryngectomy, increasing complication risks like pharyngocutaneous fistula.

Purpose of the Study:

  • To review reconstruction options following salvage total laryngectomy.
  • To analyze the short- and long-term advantages and disadvantages of various flap techniques.

Main Methods:

  • Review of current literature on reconstructive techniques after salvage total laryngectomy.
  • Analysis of free tissue transfer methods for pharyngeal reconstruction.
  • Evaluation of onlay and interposition grafts for reinforcing primary closure.

Main Results:

  • Vascularized tissue transfer from non-irradiated areas decreases major wound complications.
  • Reinforcing primary closure with vascularized grafts reduces pharyngocutaneous fistula severity and incidence.
  • Flap selection impacts both perioperative and long-term outcomes.

Conclusions:

  • Reconstruction with vascularized tissue is crucial for mitigating complications after salvage total laryngectomy.
  • Careful preoperative consideration of flap choice is essential for optimizing patient outcomes.
  • Various reconstructive options exist, each with specific benefits and drawbacks influencing patient recovery and long-term function.