TRACHEOSTOMAL STENOSIS AFTER TOTAL LARYNGECTOMY - AN ANALYSIS OF PREDISPOSING CLINICAL FACTORS

Stenosis of the terminal tracheostome is a distressing complication of total laryngectomy, A retro spective analysis of 207 patients who und erwent total laryngectomy is presented; an overall incidence of trache ostomal stenosis of 13% is reported. The incidence of tracheostomal st enosis is higher in females (26%), patients having immediate tracheoes ophageal puncture (19%), pectoralis major myocutaneous flap pharyngeal reconstruction (26%), and tracheostomal infection (50%) which is show n to be significant (P<.05). However, on multivariate analysis, only f emale sex and tracheostomal infection are independent determinants. Re cognition of these clinical factors identifies patients at increased r isk of developing this complication and thus allows appropriate periop erative planning to minimize its incidence.