A stomaplasty for total laryngectomy with a previous tracheostomy

Stomaplasties were widely used to prevent or revise stomal stenosis, however, a previous tracheostomy can limit the choice of some techniques. This study aims to deal with this condition through a novel and simple technique called "Collar stomaplasty".

This study involved 43 patients submitted for laryngectomy between 2017 and 2020. A tracheostomy 6-31 days prior to laryngectomy was performed in all cases. The collar stomaplasty, shaping the previous tracheostomy and surrounding skin, included 17 cases and the traditional X-shaped stomaplasty included 26 cases. Fisher's exact test was applied in an intergroup comparison of complications.

One out of the collar stomaplasty group demonstrated perioperative stomal infection and avascular necrosis (5.9%). Another developed stomal stenosis (5.9%). In the X-shaped stomaplasty group, necrosis at the tip of the tracheal flap occurred in 14 cases (53.8%), and stomal stenosis occurred in 5 cases (19.2%). A statistically significance occurred in stomal necrosis (p<0.05) while no statistically difference is observed in stomal stenosis (p>0.05) between these two groups.

The collar stomaplasty technique creates a laryngectomy tracheostoma by remodeling a previous tracheostomy. A wide and stable stoma, which facilitates stomal care, can be accomplished by this simple technique.