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Tracheostomal Stenosis following Total Laryngectomy

Stenosis of the tracheostoma after laryngectomy is an infrequent but often distressing postoperative complication. Recognition of possible predisposing factors will allow appropriate preventive measures in preoperative planning, surgical technique and postoperative care. We describe a surgical technique which can be utilized to correct tracheostomal stenosis or can be used at the time of initial stomal construction. Our method emphasizes mobilization of the tracheal stump, extensive excision of subcutaneous fat, excision of redundant skin and creation of a posterior-superior skin flap which is interdigitated into a vertical posterior tracheal incision. Our method is compared to other techniques described in the literature.