title: Three-layer technique to close a persistent tracheo-oesophageal fistula.
abstract: This report of a patient with a persistent tracheo-oesophageal (TE) fistula after removal of a speech valve describes a modification of the technique described by Rosen et al for closing TE. Under local anaesthesia, an incision was made above the stoma edge from 9 o'clock to 3 o'clock. The trachea was separated from the oesophagus to beyond the fistula, and the fistula tract was excised. The oesophageal opening was closed in layers and a local flap rotated from the adjacent sternocleidomastoid muscle and sutured over the oesophageal closure. The trachea was then closed separately.
authors.affiliation: ENT Unit, Department of Surgery, Universiti Putra Malaysia, Malaysia. leong_meng@time.net.my
authors.forename: Leong-Meng
authors.initials: LM
authors.lastname: Lee
authors.forename: Abdullah
authors.initials: A
authors.lastname: Razi
mesh_terms: D004947:Esophagus / Q000601:surgery; D006801:Humans; D007825:Laryngectomy; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps; D014132:Trachea / Q000601:surgery; D014138:Tracheoesophageal Fistula / Q000209:etiology / Q000601:surgery*