Surgical treatment of tracheostomal stenosis

Hypothesis: Stenosis of the tracheostome is a frequent complication followi ng total laryngectomy; the problems created by tracheostomal stenosis are t he result of reduced airflow and consequent turbulence. Many authors have s tudied etiological factors for the onset of stomal stenosis, and a number o f procedures have been recommended for the surgical correction of such sten osis, Study Design: A prospective analysis of 12 patients who underwent sur gical correction of stomal stenosis is presented, Methods: At the Institute of Clinical Otolaryngology we have recently defined a surgical technique f or the correction of stomal stenosis that combines radial incisions, V-shap ed flaps, and interposing flaps. This technique enables us to correct all t he types of stenosis, and we have treated 12 patients to date. Results: To date the average follow-up has been 17 months (range, 336 mo), and the resu lts are encouraging. Early stenosis of the tracheostoma reappeared in one p atient, who had successful repeat surgery with the same technique. Conclusi ons: Early results suggest the routine use of this surgical technique in th e treatment of stomal stenosis.