Stomal recurrence following temporary tracheostomy.
The development of a stomal recurrence after temporary tracheostomy for malignant disease of the head and neck is a rare complication, but is a well-recognized phenomenon following total laryngectomy. The risk factors and mechanisms involved are still not well understood. In a review of 265 patients having a temporary tracheostomy for head and neck malignancy, three (one per cent) developed a stomal recurrence. All recurrences occurred in the group where tracheostomy had been performed pre-resection and of these three patients all had N+ disease. The findings suggest that tumour-cell implantation is an important mechanism of stomal recurrence and that operative technique and timing of tracheostomy placement is important in reducing the risk of encountering this complication.
Department of Oral and Maxillofacial Surgery, Guy's Hospital, London, UK. wayne@whalfpenny.freeserve.co.uk
W
W
Halfpenny
M
M
McGurk
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D014139:Tracheostomy / Q000379:methods*