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End Stoma Fashioning Techniques during a Total Laryngectomy - A Review

Author(s): Abhimanyu Kadapathri, Ashwini munnangi, Vijay pillai, Vidya Bhushan Rangappa, Vivek Shetty, Narayana Subramaniam

The technique of total laryngectomy and creation of end stoma hasn’t changed much considering a century of long history of this procedure. Laryngostomal stenosis is an unfortunate problem faced by the surgeons even today. Literature shows an incidence ranging from 4% to 43%. Emphasis on techniques of stoma creation doesn’t have good detailed description in many of surgical texts. Though correction procedures for stomal stenosis were discussed in detail in literature, there is paucity of literature in the area of techniques of creation of end stoma which in turn avoid stenosis at a later date. Considering the impact of stomal stenosis on a laryngectomee’s quality of life, it is necessary for every surgeon to know how to fashion an adequate end stoma which has low rates of stenosis. Surgical techniques which interposed skin flaps into tracheal wall to break the scar have been proven successful. We review the available literature to address this issue and describe techniques used by various authors.

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