Tracheostomal stenosis is a recognized complication following total laryngectomy, with most cases occurring within the first post-operative year. We report a case of late-onset tracheostomal stenosis in a 67-year old male, presenting 10 years after total laryngectomy, bilateral neck dissection and adjuvant radiotherapy for laryngeal squamous cell carcinoma. The patient developed progressive breathlessness on neck flexion and examination revealed a stenotic tracheostoma measuring 7 × 10mm. The patient underwent stomaplasty using bilateral advancement flaps with lateral tracheal division and flap interposition, preserving the posterior tracheal wall for potential tracheoesophageal voice rehabilitation. At 2 months follow-up, the stoma remained patient at 18 × 20 mm, with resolution of symptoms. This report highlights the potential for delayed tracheostomal stenosis years after laryngectomy and describes a straightforward and effective method for its management.
Tay et al. (Wed,) studied this question.