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January 1970

Construction of the Tracheostoma

Author Affiliations

From the Department of Otolaryngology, Wayne State University School of Medicine, Detroit.

Arch Otolaryngol. 1970;91(1):78-79. doi:10.1001/archotol.1970.00770040104015

AT lT THE time of laryngectomy a permanent terminal tracheostoma is created. This should be of adequate size and permanently patent without the necessity of wearing a tracheotomy tube or any type of artificial appliance.1 In this paper we wish to describe a method of creating the tracheostoma which in our hands has been successful with minimal incidence of stenosis.

The commonest complication of a permanent tracheostomy is stenosis. This stenosis may be circumferential, or, more commonly, there is a web formation superiorly or inferiorly which obstructs the lumen.2 It must be realized that in creating a tracheostoma, we have a circumferential scar which must heal by primary or secondary intention. It is a well-recognized plastic surgical principle that whenever a scar crosses a concavity, there is a tendency for the scar to bridge the rounding thereby causing circumferential stenosis or web formation in various parts of the

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