Tracheostomal stenosis following total laryngectomy

Of 36 patients who underwent laryngectomy for cancer of the larynx, 21 patients had the stoma created in the incision, while 15 patients had it constructed caudal to it in an effort to diminish fistual formation and to keep the stoma open. All patients wore the cannula for a comparatively long time. In both groups the patients developed post-operative pharyngo-cutaneous fistulae in approximately one third of the cases, and we found no obvious difference in the stoma's ability to shrink in the two groups. However, by utilizing wide peristomal tissue excision combined with bevelling of the stump and a transposition flap in the posterior membraneous part of the trachea to widen the circumference, we believe that stomal stenosis will occur less frequently.