CC BY-NC-ND 4.0 · Indian J Plast Surg 2020; 53(03): 423-426
DOI: 10.1055/s-0040-1714769
Case Report

Treatment of Recurrent Tracheocutaneous Fistulas in the Irradiated Neck with a Two Layers–Two Flaps Combined Technique

1   Department of Plastic Surgery, Policlinico di Sant’Orsola, DIMES, University of Bologna, Bologna, Italy
,
G. Sapino
2   Department of Plastic Surgery, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy
,
M. Alicandri-Ciufelli
3   Department of Otolaryngology, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy
,
F. Canzano
3   Department of Otolaryngology, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy
,
L. Presutti
3   Department of Otolaryngology, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy
,
G. De Santis
2   Department of Plastic Surgery, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy
› Author Affiliations

Abstract

The development of a tracheocutaneous fistula (TCF) is a well-documented complication after tracheostomy, especially in chronic morbid patients, in whom tubes or cannulas are left in place over time, or in irradiated patients.

Surgical treatments are therefore needed which range from simple curettage and dressings to local skin flaps, muscle flaps and, in the more complex cases, microsurgical free tissue transfers.

We present a novel combined technique used to successfully treat recurrent TCFs in irradiated patients, involving a superiorly based turnover fistula flap and a sternocleidomastoid transposition flap.



Publication History

Article published online:
28 July 2020

© 2020. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Feehs KR, Maslan JT, Kirse DJ. Superiorly-based turnover skin flap: Pediatric tracheocutaneous fistula closure. Int J Pediatr Otorhinolaryngol 2018; 107: 21-24
  • 2 Gallagher TQ, Hartnick CJ. Tracheocutaneous fistula closure. Adv Otorhinolaryngol 2012; 73: 76-79
  • 3 Rennekampff HO, Tenenhaus M. Turnover flap closure of recalcitrant tracheostomy fistula: a simplified approach. Plast Reconstr Surg 2007; 119 (02) 551-555
  • 4 Royer AK, Royer MC, Ting JY, Weisberger EC, Moore MG. The use of a prefabricated radial forearm free flap for closure of a large tracheocutaneous fistula: a case report and review of the literature. J Med Case Reports 2015; 9: 251
  • 5 Hernot S, Wadhera R, Kaintura M. et al. Tracheocutaneous fistula closure: comparison of rhomboid flap repair with Z plasty repair in a case series of 40 patients. Aesthetic Plast Surg 2016; 40 (06) 908-913
  • 6 Tasca RA, Clarke RW. Tracheocutaneous fistula following paediatric tracheostomy–a 14-year experience at Alder Hey Children’s Hospital. Int J Pediatr Otorhinolaryngol 2010; 74 (06) 711-712
  • 7 Kulber H, Passy V. Tracheostomy closure and scar revisions. Arch Otolaryngol 1972; 96 (01) 22-26
  • 8 Kitazawa T, Shiba M. Closure of a tracheocutaneous fistula with a local turnover flap combined with pregrafted palatal mucosa: a case report. Eplasty 2016; 16: e30
  • 9 Kamiyoshihara M, Nagashima T, Takeyoshi I. A novel technique for closing a tracheocutaneous fistula using a hinged skin flap. Surg Today 2011; 41 (08) 1166-1168
  • 10 Jones LF, Farrar EM, Roberts DJH, Moor JW. Revisiting the sternocleidomastoid flap as a reconstructive option in head and neck surgery. J Laryngol Otol 2019; (e-pub ahead of print) DOI: 10.1017/S0022215119001592.