Stenosis of the tracheostoma following laryngectomy is not an infrequent complication. It may occur immediately after the operation, or it may develop years later. The stenosis, especially with the addition of crusting, can lead to an emergency situation, and can, on occasion, result in asphyxia.
Careful construction of the stoma, oblique transection of the trachea, and removal of excessive fat and skin reduce the incidence of stenosis. In addition to the above, I feel that early omission of the tracheostomy tube (i.e., on the fifth to seventh postoperative day) is of value. Common causes of stenosis are: (1) excessive scar tissue (usually as a result of postoperative infection or fistula formulation); (2) keloid formation; (3) excessive fat around the stoma; (4) defec
Fig. 1. A, skin flaps are elevated on each side of the stenosed stoma. B, scar tissue and fat are excised around the stomal orifice. C, if necessary,
MONTGOMERY WW. Stenosis of Tracheostoma. Arch Otolaryngol. 1962;75(1):62–65. doi:10.1001/archotol.1962.00740040066005