A new surgical technique to prevent tracheostomal stenosis

Stenosis of the tracheostoma after surgery is a frequent complication. According to the literature, the incidence of this complication ranges from 4% to 42%. Once stenosis occurs, the patient either has to use a stent or needs surgical revision. Many techniques for creating the tracheostoma to prevent stenosis have been attempted, such as by using skin triangles. We performed a simple surgical technique for creating tracheostoma using buried sutures in 23 consecutive patients (21 males, 2 females) after total pharyngolaryngoesophagectomy, between November 2011 and January 2013. The follow-up period of these patients varies from 5 to 25 months, and none of them have needed surgical revision. We speculate that tracheostomal stenosis is created by scar contracture because of excessive scar tissue, skin around the stoma and supportless tracheal ring. This new surgical technique yields good results for preventing tracheostomal stenosis.