Stomal recurrence following temporary tracheostomy

The development of a stomal recurrence after temporary tracheostomy for mal ignant disease of the head and neck is a rare complication, but is a well-r ecognized phenomenon following total laryngectomy. The risk factors and mec hanisms involved are still not :well understood. In a review of 265 patient s having a temporary tracheostomy for head and neck malignancy, three (one per cent) developed a stomal recurrence. All recurrences occurred in the gr oup where tracheostomy had been performed pre-resection and of these three patients all had N+ disease. The findings suggest that tumour-cell implanta tion is an important mechanism of stomal recurrence and that operative tech nique and tinting of tracheostomy placement is important in reducing the ri sk of encountering this complication.