Detachment of the trachea following total laryngectomy

Two cases of tracheal detachment following laryngectomy are described and a suitable method of repair is suggested. The possible causes of detachment of the trachea following total laryngectomy may be summarized as follows: (a) Poor surgical technique when fashioning the tracheostome. (b) Poor quality of the tissues. (c) Poor general condition of the patient. (d) Excessive tension on the trachea. Reconstruction of the tracheostome requires:- (a) Elimination of infection by antibiotics and total debridement of non-viable tissue. (b) Absence of tension on the wound and the raising of adequate skin flaps. Should these conditions be met, the method of repair described above has been shown to be satisfactory.