Tracheal Stoma Problems

Abstract

THE TWO major problems related to the permanent tracheostomy that is established following laryngectomy are delayed infiltration of the surrounding tissues by persistent tumor, and benign scar contracture at the skin and mucosa junction. Persistent tumor infiltration is a far greater threat to the prognosis. Benign stricture is less threatening because it is slow in forming and is surgically correctable. Both complications have come to our attention for evaluation because we believed that our experience did not support, nor was it supported by, the literature nor a general inference. Keim et al¹have reported 15% (17 instances) occurrences of peristomal persistence of carcinoma in a series of 116 patients who had undergone laryngectomy with and without a combined or subsequent neck dissection. Our experience, which will be presented, is 3% (four instances) in a study of 138 patients with comparable disease and surgery. While there is no occurrence rate