Modified Laryngotracheal Separation : A New Operation for Prevention of Tracheo-Brachiocephalic Artery Fistula

Abstract

Purpose: Laryngotracheal separation is often performed for aspiration in severe psychophysiologic disorders. Tracheo-brachiocephalic fistula is a severe complication and causes fatal bleeding. Therefore prevention should be established. We have tried to decrease the incidence rate of tracheo-brachiocephalic fistula by modification of laryngotracheal separation. Operation: The operation is performed by an H-shaped skin incision. The trachea is not lifted up, and the skin flap is lowered to the trachea level. Results: This operation has been performed in 7 cases and had no major complication. A big tracheal stoma could be established, so it might be better against constriction of the tracheal stoma. Conclusion: This surgery should be useful to prevent tracheo-brachiocephalic fistula due to trachea position.