title: Worldwide, multicenter study of peristomal geometry and morphology in laryngectomees and its clinical effects.
abstract: BACKGROUND
  The purpose of this study was to improve attachment of automatic tracheostoma valves, the knowledge on tracheostoma geometry, and its clinical influences preferred. This article investigates whether the number of removed trachea rings, incision of the sternocleidomastoid muscles, neck dissection, reconstruction, time after operation, and age have any effect on the (peri)stomal geometry of the patient.
  
  
  METHODS
  (Peri)stomas of 191 patients from 10 institutes worldwide were photographed, measured, and compared.
  
  
  RESULTS
  Paired comparisons between the number of trachea rings removed showed significant differences in horizontal and vertical trachea-opening diameters, but failed to demonstrate an effect in the depth of the stoma. T tests did not demonstrate significant differences in peristomal geometry between the sternocleidomastoid-cleaved and non-cleaved group.
  
  
  CONCLUSIONS
  The number of removed tracheal rings during laryngectomy does not seem to influence stoma depth. However, this study does not demonstrate that cleaving the sternocleidomastoid muscle (SCM) at the time of a laryngectomy will result in a geometrically flatter stoma.
authors: Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors: Tjouwke A
authors: TA
authors: van Kalkeren
authors: Eduard B
authors: EB
authors: van der Houwen
authors: Mari Anne E
authors: MA
authors: Duits
authors: Frans J
authors: FJ
authors: Hilgers
authors: Ana
authors: A
authors: Hebe
authors: Badr E
authors: BE
authors: Mostafa
authors: George
authors: G
authors: Lawson
authors: Zuriñe
authors: Z
authors: Martinez
authors: Virginie
authors: V
authors: Woisard
authors: Gino
authors: G
authors: Marioni
authors: Dean
authors: D
authors: Ruske
authors: Philippe
authors: P
authors: Schultz
authors: Wendy J
authors: WJ
authors: Post
authors: Bart J
authors: BJ
authors: Verkerke
authors: Bernard F A M
authors: BF
authors: van der Laan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007391:International Cooperation; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000534:rehabilitation* / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009334:Neck Muscles / Q000601:surgery*; D009426:Netherlands; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment; D018434:Sickness Impact Profile; D013068:Speech Production Measurement; D054047:Surgical Stomas; D014139:Tracheostomy / Q000379:methods* / Q000534:rehabilitation; D016896:Treatment Outcome; D014833:Voice Quality