title: Tracheostomaplasty: A surgical method for improving retention of an intraluminal stoma button for hands-free tracheoesophageal speech.
abstract: BACKGROUND
  We describe a minimally invasive surgical technique, tracheostomaplasty, to overcome anatomical deformities of the stoma that preclude successful retention of a stoma button for hands free tracheoesophageal (TE) speech.
  
  
  METHODS
  We conducted a retrospective analysis of 21 patients who underwent tracheostomaplasty after laryngectomy to accommodate an intraluminal valve attachment for hands-free TE speech.
  
  
  RESULTS
  Sixteen men and 5 women (median age, 65 years; median follow-up, 27.7 months) underwent tracheostomaplasty; 6 patients developed a mild cellulitis that required therapy and 5 patients required a minor revision surgery. At last follow-up, 15 (71%) patients successfully achieved hands-free TE speech using an intraluminal stoma button. Three patients only retained the intraluminal device to facilitate digital occlusion. Tracheostomaplasty failed in 3 patients because of granulation tissue formation or stomal stenosis.
  
  
  CONCLUSIONS
  Tracheostomaplasty is a successful technique to improve intraluminal retention of a stoma button for hands-free TE speech in laryngectomy patients.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Mauricio A
authors.initials: MA
authors.lastname: Moreno
authors.forename: Jan S
authors.initials: JS
authors.lastname: Lewin
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Hutcheson
authors.forename: Julie K
authors.initials: JK
authors.lastname: Bishop Leone
authors.forename: Denise A
authors.initials: DA
authors.lastname: Barringer
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Reece
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005205:Fascia / Q000637:transplantation; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D013072:Speech, Esophageal / Q000295:instrumentation; D014139:Tracheostomy / Q000009:adverse effects / Q000379:methods