Abstract
A new surgical technique was deviced in order to prevent the stricture of the permanent tracheostoma. This procedure is composed of two principles ; that is, to avoid the damage of the cartilage at the entrance of the trachea and to cover the margin of the tracheal mucosa with the skin by the inverting suture with the round needle and the nylon thread.
The first stage: The perichondrium of the second tracheal cartilage is stripped and then the cartilage is removed. The trachea is horizontally divided just under the inferior margin of the first tracheal cartilage and the tube is inserted into the trachea for general anesthesia.
The second stage: After the total laryngectomy is performed, five inverting sutures are tied at the cartilaginous portion of the tracheal end and the margin of the skin covers the mucosal edge of the trachea. These sutures should be carefully carried out in the way which the needle must not pierce the third tracheal cartilage but only the mucosa. The interrupted suture is done at the membranedus portion of the trachea. Any cannula is not used after the surgery.
