Tracheal stomaplasty in tracheoesophageal punctured alaryngeal patients: is it a must?

ABSTRACT

The purpose of this study is to highlight the stenotic effect of tracheoesophageal puncture and the implanted voice prosthesis on the tracheostoma of alaryngeal patients and to evaluate the role of primary tracheostomaplasty in prevention of this stenosis. This was a prospective clinical study conducted in the Otolaryngology Department of Tanta University Egypt. The records of seventy-seven laryngectomized patients who were operated on between January 2000 and February 2006 were reviewed and divided into two major groups; those with tracheoesophageal puncture [puncture-study group] and those without [control group]. The two groups were then subdivided between those with stomaplasty [subdivision A] and those without [subdivision B]. The rates of tracheostoma stenosis in the two major groups and in the four subdivisions were compared and statistically analyzed considering different risk factors. In the puncture group, the total incidence of tracheostoma stenosis was 18 in 45 cases [40%] including 3 in 24 cases in subdivision-A [12.5%] and 15 in 21 cases in subdivision-B [71%], while its total incidence in the control group was 6 in 32 cases [19%] including 1 in 17 cases in subdivision A [9%] and 5 in 15 cases in subdivision B [33%]. On analysis, the risk factors within both the major groups were almost similar. Performing primary tracheostomaplasty after completion of total laryngectomy dramatically reduces the stenotic effect of this puncture and other risk factors