Roh Jong-Lyel
Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Oral Oncol. 2023 Mar;138:106328. doi: 10.1016/j.oraloncology.2023.106328. Epub 2023 Feb 2.
Tracheostomal stenosis is a common distressing problem for surgeons and patients after laryngectomy. The stenosis occurs in up to 44% of laryngectomized patients, according to different contributing factors. Various surgical techniques have been introduced to treat tracheostomal stenosis, showing no clear advantages over the other methods. Only a few studies have reported stomal widening techniques with the preservation of tracheoesophageal puncture (TEP). Tracheostomal restenosis may occur after the stomaplasty, often requiring revision surgery. A new surgical method was developed to preserve TEP and avoid stomal restenosis, including the bilateral vertical incisions of tracheostoma stenosis and anchoring to the clavicle. This operative technique is relatively safe, simple, less invasive and time-consuming, and preserves the TEP and voice prosthesis. Therefore, this article presents the surgical procedure, potential indications, and pros and cons of the new widening method of tracheostomal stenosis.
气管造口狭窄是喉切除术后外科医生和患者面临的一个常见且令人苦恼的问题。根据不同的促成因素，高达44%的喉切除患者会出现狭窄。已经引入了各种外科技术来治疗气管造口狭窄，但与其他方法相比没有明显优势。只有少数研究报道了保留气管食管造瘘（TEP）的造口扩大技术。造口成形术后可能会发生气管造口再狭窄，通常需要进行翻修手术。一种新的手术方法被开发出来以保留TEP并避免造口再狭窄，包括气管造口狭窄的双侧垂直切口并固定于锁骨。这种手术技术相对安全、简单、侵入性小且耗时短，并且保留了TEP和语音假体。因此，本文介绍了气管造口狭窄新扩大方法的手术步骤、潜在适应证以及优缺点。
