Sankari N Vidya, Mohan Jayashree, Simon Paul, Sivakumar Indumathi, Subamanium Yogesh
Vinayaka Mission's Snakarachariyar Dental College, Salem, Tamil Nadu, India.
Vishnu Dental College, Bhimavaram, Andhra Pradesh, India.
J Indian Prosthodont Soc. 2015 Jan-Mar;15(1):76-82. doi: 10.4103/0972-4052.155047.
Patients with a tracheostomy stoma experience compromised speech and function due to the associated changes in airflow patterns. Rehabilitation of a patient with tracheal stoma is a highly challenging task. The main objective is to design an inexpensive, easily fabricated stomal prosthesis for postlaryngectomy patients who require prolonged tracheotomy. This clinical case report describes a 29-year-old male patient who underwent for tracheotomy 3 months before for respiratory distress following a suicidal attempt. Hence tracheotomy was done, and the patient has been with the tracheostomal tube since surgery for the past 3 months. Laryngoscopy examination reported as restricted bilateral vocal cord movements, and the cords were in the adducted position with minimal glottic chink. No history of difficulty in swallowing. On examination, no scar or ulceration is seen around the stoma. The skin around the stoma is healthy. The patient was referred to the oral and maxillofacial Prosthodontics Department from the Department of ENT. The patient's old tracheostomal tube was used as the dimensions of the custom made tracheal prosthesis without making a functional impression of the mature stoma. A tracheal button was made with 2 mm polyethylene urethane sheet to maintain the airway patency of the mature stoma. Width and length of the old tracheostomal tube were measured and customized with polyurethane sheet by directly flaming over heat. The finished product was thin, flexible, maintains enhanced tear strength, require no tapes or adhesives and less technique sensitive. These properties of the prosthesis make more advantageous than the commercially available tracheal buttons. The result in this patient was excellent with no postoperative complications. An innovative approach for fabrication of tracheostomal prosthesis was discussed to increase its successful use in tracheostomal patients. The patient's old tracheostomal tube was used as the dimensions of the custom made tracheal prosthesis without making a functional impression of the mature stoma. The finished product was thin, flexible, maintains enhanced tear strength, require no tapes or adhesives and less technique sensitive. These properties of the prosthesis makes more advantageous than the commercially available tracheal buttons. The result in this patient was excellent with no postoperative complications.
气管造口患者由于气流模式的相关变化而出现言语和功能受损。气管造口患者的康复是一项极具挑战性的任务。主要目标是为需要长期气管切开术的喉切除术后患者设计一种价格低廉、易于制作的造口假体。本临床病例报告描述了一名29岁男性患者，该患者在自杀未遂后因呼吸窘迫于3个月前接受了气管切开术。因此进行了气管切开术，患者自手术以来的过去3个月一直佩戴气管造口管。喉镜检查报告显示双侧声带运动受限，声带处于内收位置，声门裂极小。无吞咽困难病史。检查时，造口周围未见瘢痕或溃疡。造口周围皮肤健康。该患者从耳鼻喉科转诊至口腔颌面修复科。使用患者原来的气管造口管作为定制气管假体的尺寸，而没有对成熟造口进行功能性印模。用2毫米的聚亚安酯薄片制作了一个气管钮，以维持成熟造口的气道通畅。测量原来气管造口管的宽度和长度，并通过在火上直接加热用聚氨酯薄片进行定制。成品薄且柔韧，具有增强的抗撕裂强度，无需胶带或粘合剂，对技术的敏感性较低。该假体的这些特性使其比市售的气管钮更具优势。该患者的结果极佳，无术后并发症。讨论了一种制作气管造口假体的创新方法，以增加其在气管造口患者中的成功应用。使用患者原来的气管造口管作为定制气管假体的尺寸，而没有对成熟造口进行功能性印模。成品薄且柔韧，具有增强的抗撕裂强度，无需胶带或粘合剂，对技术的敏感性较低。该假体的这些特性使其比市售的气管钮更具优势。该患者的结果极佳，无术后并发症。
