A stomaplasty for total laryngectomy with a previous tracheostomy

Auris Nasus Larynx. 2023 Dec;50(6):929-934. doi: 10.1016/j.anl.2023.04.004. Epub 2023 May 3.

Abstract

Objective: 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".

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Stomal stenosis; Stomaplasty; Total laryngectomy; Tracheostomy.

MeSH terms

  • Constriction, Pathologic
  • Humans
  • Laryngectomy / methods
  • Surgical Stomas*
  • Trachea
  • Tracheostomy* / methods