THE SPECTER of peristomal recurrence hangs over the laryngectomized patient as one of the most insidious and lethal complications which can occur. Detection is often difficult even for the skilled and careful observer, and survival with the most aggressive treatment is rare. Our purpose in this paper is to analyze our experience with recurrence in the peristomal region, to define certain factors of significance in its etiology, and to suggest possible preventive measures.
We may define postlaryngectomy peristomal recurrence as a diffuse infiltrate of neoplastic tissue at the junction of the amputated trachea and the skin. It may be localized to one side of the stoma, slowly producing a bulge of the immediately adjacent tracheal wall, or it may encircle the stoma, causing a gradual constriction of the aperture that is almost imperceptible, appearing at any time from six weeks to two or more years following laryngectomy. Occasionally the recurrence