Abstract
After tracheostomy, the tracheostomy tube is removed when not needed. In cases when the tracheo-cutaneous fistula does not close automatically, it must be closed by surgery. Fundamentally, we close the tracheo-cutaneous fistula by a hinge flap (hinge group) ; but when using this procedure is difficult, we add an anterior chest skin flap (anterior chest skin flap group). Here, we examined the results for a total of 70 cases (41 male, 29 female) of tracheo-cutaneous fistula closure performed over a 10-year period from 2004 to 2013. The average age was 63 years old (13 to 83). The primary diseases for tracheostomy included 26 thyroid tumors, 13 oral cancers, and 9 oropharyngeal cancers. The tracheo-cutaneous fistula closure types were 62 hinge group (89%) and 8 anterior chest skin flap group (11%). The maximum diameter of the stoma before operation was significantly larger with the anterior chest skin flap group than with the hinge group. There was no significant difference in time from tracheostomy to closure of trachea-cutaneous fistula between the 2 groups. Postoperative complications arose in 18 cases (29%) in the hinge group and in 4 cases (50%) in the anterior chest skin flap group. The 18 cases presenting postoperative failure of the sutures or infection had a significant history of radiotherapy. A total of 16 cases automatically closed between 2 weeks and 6 months (median 1.5 months), but 2 cases remain unclosed to date.
