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.
Halfpenny
W
W
Department of Oral and Maxillofacial Surgery, Guy's Hospital, London, UK. wayne@whalfpenny.freeserve.co.uk
McGurk
M
M
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*