Depressed scars and tracheal tugging that cause skin traction during swallowing without tracheocutaneous fistulae following tracheostomy can pose a serious problem. We report the cases of two patients with a depressed scar and tracheal tugging.
The first case was that of a 12-year-old boy with Pierre Robin sequence. The scar and surrounding skin were de-epithelialized, and a dermal fat flap was elevated, overlapped, and sutured to the depression. Thereafter, the bilateral sternohyoid muscles were sutured in the midline.
The second case was that of a 51-year-old woman. The recess was filled with a dermal fat flap, and the left sternohyoid muscle and medial sternal head of the right sternocleidomastoid muscle were sutured in the midline.
Postoperative recurrence was not observed in either patient.
There are several reports on the treatment of tracheocutaneous fistulas after tracheostomy；however, few discussed the treatment of depressed deformities and tracheal tugging. Grafting of a dermal fat flap, artificial dermis, or allogenic dura, and shifting of the strap muscles to improve the depressed shape and prevent reattachment of the skin to the trachea yield good results.
Future studies are necessary to provide more treatment options.
