ABSTRACT
Tracheostomy is a general surgical procedure performed by
many surgeons on a routine basis. A tracheostomy orifice closes by
secondary intention in many routine cases. The following case
report is about a 54-year-old patient diagnosed with squamous cell
carcinoma of the right vocal cord who underwent micro laryngeal excision
with tracheostomy followed by radiation therapy. After 2 years, on
decannulation he had a persistent tracheocutaneous fistula. A
tracheocutaneous fistula is commonly regarded as a pathological
complication of temporary tracheostomy that results due to failure of
spontaneous tracheostome closure post decannulation. Various
factors present a challenge for the surgeon in managing such a
complication such as chronic cough, infection and other co-morbidities.
The need for a secondary closure is also warranted when the stoma does
not close on itself within a specified time.
Keywords:
Tracheostomy, Pectoralis major musculocutaneous flap, fistula
Key Clinical Message:
Tracheocutaneous fistula presents a challenge to the surgeon as
different factors affects its formation and healing. A multidisciplinary
approach and proper patient counselling, duration of
cannulation.comorbidies helps in prognosis and outcome.