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Tracheal advancement flap for postlaryngectomy stomal stenosis
B H Campbell1, B W Rubach, T L McAuliffe
1Department of Otolaryngology and Human Communication, Medical College of Wisconsin, Milwaukee 53226, USA.
Background:
Tracheal stenosis can be a troubling consequence of laryngectomy. Some revision techniques disturb the posterior stoma site of a current or planned tracheoesophageal puncture (TEP).
Methods:
A revision technique which advances the trachea out of the stoma, divides the anterior tracheal wall, and leaves the posterior tracheal wall undisturbed was designed. The paper describes the technique in detail. "Success" was defined as producing a stable, trouble-free stoma requiring no stenting; "partial success" as an improved stoma requiring some stenting; and "failure" as no improvement and continuous stenting.
Results:
Fifteen patients underwent the procedure. Median time from laryngectomy to revision was 10 months. Preoperative to postoperative median stoma size increased from 63 mm2 to 135 mm2. Seven patients were classified as successful, six patients were partially successful, and two patients had no improvement.
Conclusion:
The tracheal advancement flap is a safe technique for the laryngectomy patient who has undergone or might undergo voice restoration.