Tracheostomal stenosis following total laryngectomy

Tracheostomal stenosis, a relatively common complication following total laryngectomy, may be attributable to multiple factors, including infection, radiation, poor surgical technique, and the metabolic health of the patient. If careful technique is utilized and attention to details is given in the initial construction of the stoma, the chance of a successful outcome is much greater. Many techniques are available to the surgeon, but the successful procedures all include some method whereby the circular scar is broken up through the use of Z plasties or skin flaps, or segments of the circular scar are lengthened relative to other segments, as in the beveling technique. It is important to view a secondary revision as a true reconstructive operation and not as a minor revision, in order to achieve a competent functional tracheal stoma.