The superiorly based flap tracheostomy(SBFT) has been advocated as an new technique
of tracheostomy of manage a wide variety of causes of upper airway obstruction. THis
technique has particular applicability in patients who require long term tracheostomy such as
in bilateral vocal cord paralysis and severe obstructive sleep apnea. SBFT has numerous
advantages such as shortening of the between the skin and trachea; construction of a
self-sustaining tract; circumferential mucocutaneous junction to reduce infection, granulation
tissue, bleeding, and stenosis of the tract; avoidance of the laryngotracheal damage; easy
placement of a tracheostomal stent to promote speech, coughing and swallowing. Most of all,
this technique cna reduced the suprastomal buckling by the support of the superiorly based
tracheal flap, and thus prevents the stenosis of suprastomal airway. The disadvantage of
SBFT is more time-consuming procedure than the conventional tracheostomy.
A retrospective analysis of 8 patients undergoing SBFT between June, 1994 and March, 1995
in Dankook University Hospital was performed to present the surgical technique and
complication rates. The average duradion of follow up was 11 months. The complications
were consisted of a wound infection and a stomal granulation. The other complications
including wound dehiscence, tracheitis, pneumonia, tracheal granulation, stomal narrowing and
subglottic stenosis were not experienced.
|