TRACHEAL ADVANCEMENT FLAP FOR POSTLARYNGECTOMY STOMAL STENOSIS

Background: Tracheal stenosis can be a troubling consequence of laryng ectomy. Some revision techniques disturb the posterior stoma site of a current or planned tracheoesophageal puncture (TEP). Methods: A revis ion technique which advances the trachea out of the stoma, divides the anterior tracheal wall, and leaves the posterior tracheal wall undist urbed was designed. The paper describes the technique in detail. ''Suc cess'' 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. R esults: Fifteen patients underwent the procedure. Median time from lar yngectomy to revision was 10 months. Preoperative to postoperative med ian stoma size increased from 63 mm(2) to 135 mm(2). Seven patients we re classified as successful, six patients were partially successful, a nd two patients had no improvement. Conclusion: The tracheal advanceme nt flap is a safe technique for the laryngectomy patient who has under gone or might undergo Voice restoration. (C) 1997 John Wiley & Sons, I nc.