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The end of tracheostomal stenosis? Introducing the fish mouth technique

Published online by Cambridge University Press:  25 November 2021

H S Gendeh ,
M Azman ,
M Mat Baki  and
A S Mohamed
H S Gendeh
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
M Azman
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
M Mat Baki*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
A S Mohamed
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
*
Author for correspondence: Professor Marina Mat Baki, Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia E-mail: marinadrent@gmail.com Fax: +603 9145 6647
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Abstract

Background

Post-laryngectomy tracheostomal stenosis is common and often results in an inadequate airway. Several techniques have been described to minimise tracheostomal stenosis. The star technique involves an ‘X’ incision with four flaps sutured into the trachea. The petal technique involves two inferior flaps on either side being sutured into the trachea. The authors combined the star and petal techniques, resulting in an innovative fish mouth technique.

Methods and results

This innovation involves two lateral skin flaps being sutured into an incision on either side of the lateral wall of the trachea. This results in an elongated, broadened and elliptical tracheostoma, mimicking that of a fish mouth.

Conclusion

Benefits of the fish mouth technique include adequate stoma size for respiration, easier clearing of secretions, self-sufficiency without a stent, easier cleaning of a tracheoesophageal voice prosthesis, and stoma occlusion for voice production. The fish mouth technique is easily reproducible and suitable for those with a voice prosthesis.

Keywords

LarynxLaryngectomyConstrictionTracheaSurgical Flaps
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 4 , April 2022 , pp. 368 - 372
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Professor M Mat Baki takes responsibility for the integrity of the content of the paper

References

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