Tracheoesophageal puncture site closure with sternocleidomastoid musculocutaneous transposition flap
Introduction: Tracheoesophageal voice prosthesis is highly effective in providing speech after total laryngectomy. Although it is a safe method, in certain cases dilatation or leakage occurs around the prosthesis that needs closure of tracheoesophageal fistula. Both non-surgical and surgical methods...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2015-09-01
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| Series: | Indian Journal of Plastic Surgery |
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| author | Dushyant Jaiswal Prabha Yadav Vinay Kant Shankhdhar Rajendra Suresh Gujjalanavar Prashant Puranik |
| author_facet | Dushyant Jaiswal Prabha Yadav Vinay Kant Shankhdhar Rajendra Suresh Gujjalanavar Prashant Puranik |
| author_sort | Dushyant Jaiswal |
| collection | DOAJ |
| description | Introduction: Tracheoesophageal voice prosthesis is highly effective in providing speech after total laryngectomy. Although it is a safe method, in certain cases dilatation or leakage occurs around the prosthesis that needs closure of tracheoesophageal fistula. Both non-surgical and surgical methods for closure have been described. Surgical methods are used when non-surgical methods fail. We present the use of the sternocleidomastoid musculocutaneous (SCMMC) transposition flap for the closure of tracheoesophageal fistula. Materials and Methods: An incision is made at the mucocutaneous junction circumferentially around the tracheostoma. Tracheoesophageal space is dissected down to and beyond the fistula. The tracheoesophageal tract is divided. The oesophageal mucosa is closed with simple sutures. Then SCMMC transposition flap is raised and transposed to cover sutured oesophagus and the defect between the oesophagus and the trachea. Results: This study was done prospectively over a period of 1 year from June 2012 to May 2013. This technique was used in patients with pliable neck skin. In nine patients, this procedure was done (inferior based flap in nine cases) and it was successful in eight patients. In one case, there was dehiscence at the leading edge of flap with oesophageal dehiscence, which required a second procedure. In two cases, there was marginal necrosis of flap, which healed without any intervention. Nine patients in this series were post-radiation. Conclusion: This method of closure is simple and effective for patients with pliable neck skin, who require permanent closure of the tracheoesophageal fistula. |
| format | Article |
| id | doaj-art-dc52ee11754c4d2fb8afda25fc4cbec8 |
| institution | OA Journals |
| issn | 0970-0358 1998-376X |
| language | English |
| publishDate | 2015-09-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Plastic Surgery |
| spelling | doaj-art-dc52ee11754c4d2fb8afda25fc4cbec82025-08-20T02:21:37ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2015-09-01480327828210.4103/0970-0358.173125Tracheoesophageal puncture site closure with sternocleidomastoid musculocutaneous transposition flapDushyant Jaiswal0Prabha Yadav1Vinay Kant Shankhdhar2Rajendra Suresh Gujjalanavar3Prashant Puranik4Department of Plastic and Microvascular Services, Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Plastic and Microvascular Services, Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Plastic and Microvascular Services, Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Plastic and Microvascular Services, Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Plastic and Microvascular Services, Tata Memorial Hospital, Mumbai, Maharashtra, IndiaIntroduction: Tracheoesophageal voice prosthesis is highly effective in providing speech after total laryngectomy. Although it is a safe method, in certain cases dilatation or leakage occurs around the prosthesis that needs closure of tracheoesophageal fistula. Both non-surgical and surgical methods for closure have been described. Surgical methods are used when non-surgical methods fail. We present the use of the sternocleidomastoid musculocutaneous (SCMMC) transposition flap for the closure of tracheoesophageal fistula. Materials and Methods: An incision is made at the mucocutaneous junction circumferentially around the tracheostoma. Tracheoesophageal space is dissected down to and beyond the fistula. The tracheoesophageal tract is divided. The oesophageal mucosa is closed with simple sutures. Then SCMMC transposition flap is raised and transposed to cover sutured oesophagus and the defect between the oesophagus and the trachea. Results: This study was done prospectively over a period of 1 year from June 2012 to May 2013. This technique was used in patients with pliable neck skin. In nine patients, this procedure was done (inferior based flap in nine cases) and it was successful in eight patients. In one case, there was dehiscence at the leading edge of flap with oesophageal dehiscence, which required a second procedure. In two cases, there was marginal necrosis of flap, which healed without any intervention. Nine patients in this series were post-radiation. Conclusion: This method of closure is simple and effective for patients with pliable neck skin, who require permanent closure of the tracheoesophageal fistula.http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.173125sternocleidomastoid musculocutaneous flaptracheoesophageal puncture (tep) closureflap for tracheoesophageal puncture site |
| spellingShingle | Dushyant Jaiswal Prabha Yadav Vinay Kant Shankhdhar Rajendra Suresh Gujjalanavar Prashant Puranik Tracheoesophageal puncture site closure with sternocleidomastoid musculocutaneous transposition flap Indian Journal of Plastic Surgery sternocleidomastoid musculocutaneous flap tracheoesophageal puncture (tep) closure flap for tracheoesophageal puncture site |
| title | Tracheoesophageal puncture site closure with sternocleidomastoid musculocutaneous transposition flap |
| title_full | Tracheoesophageal puncture site closure with sternocleidomastoid musculocutaneous transposition flap |
| title_fullStr | Tracheoesophageal puncture site closure with sternocleidomastoid musculocutaneous transposition flap |
| title_full_unstemmed | Tracheoesophageal puncture site closure with sternocleidomastoid musculocutaneous transposition flap |
| title_short | Tracheoesophageal puncture site closure with sternocleidomastoid musculocutaneous transposition flap |
| title_sort | tracheoesophageal puncture site closure with sternocleidomastoid musculocutaneous transposition flap |
| topic | sternocleidomastoid musculocutaneous flap tracheoesophageal puncture (tep) closure flap for tracheoesophageal puncture site |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.173125 |
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