title: A new surgical technique for primary closure of long-term tracheostomy.
abstract: OBJECTIVE
  To delineate a technique that avoids the complications associated with surgical closure of long-term or permanent tracheostomy (LTT). Study design A case series that describes the technique and clinical outcomes.
  
  
  METHODS
  Thirty-seven of 300 patients with a previously established LTT underwent primary surgical closure of their stoma after their underlying disease had been resolved. The surgical technique combined a turnover flap with medialization of fibroadipose tissue, followed by additional closure with an advancement skin flap.
  
  
  RESULTS
  After a mean follow-up of 3.2 years, no patient developed major complications. Four patients developed minor complications, which responded to conservative treatment. In all patients, the functional results were satisfactory, as were the cosmetic results, with the exception of 1 case. None required re-tracheostomy.
  
  
  CONCLUSIONS
  This simple and reliable new surgical technique for closing LTT avoids the potential failures and complications encountered in previously published procedures.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Hebrew University School of Medicine, Hadassah Medical Center, Jerusalem, Israel. ron@eliashar.com
authors.forename: Ron
authors.initials: R
authors.lastname: Eliashar
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Sichel
authors.forename: Isaac
authors.initials: I
authors.lastname: Eliachar
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D013524:Surgical Flaps; D013997:Time Factors; D014139:Tracheostomy / Q000379:methods*