Abstract
The patient was a 21-year-old male who was diagnosed with congenital malformation on the basis of peculiar facial features, thoracic kyphosis, and mental retardation. A tracheostomy with an anterior cricoid cartilage resection and the final correction of kyphosis were performed at the ages of 13 and 20, respectively. He was referred to our department for tracheostomy closure. The diameter of the tracheostomy orifice was 14 × 16 mm. Respiration was maintained even after the tracheostomy was temporarily closed with medical tape, ascertaining the legitimacy of the tracheostomy closure. During the operation, a hinged skin flap was created by leaving an island of epidermis cranial to the tracheostomy orifice, with the surrounding epidermis removed. The epidermal portion of the hinged flap was folded caudally and suture-fixed to the orifice. The hinged skin flap was further strengthened by a right sternohyoid muscle flap. He was discharged on the seventh postoperative day without aspiration pneumonia or respiratory distress on the adjusted diet and has been doing well for two years. Tracheostomy closure with a hinged skin flap to reconstruct the anterior tracheal wall can be a safe and useful approach for patients with seemingly “permanent” tracheostomy with anterior cricoid cartilage removal.
