The tracheocutaneous fistula(TCF) may develop infrequently as a complication after
tracheostomy. Prolonged tracheostomy tube dependence increases the risk of TCF developing,
and ingrowth of stratified squamous epithelium lines the furrow connecting the tracheal
mucosa and the skin, accounting for persistence of the fistulous tract. Such fistulas are a
nuisance and create nursing and social problems including poor hygiene, aspiration, difficulty
with speech, and depletion of pulmonary reserve. Surgical closure has generally been
successful by primary closure, fistulectomy with primary closure, and closure by secondary
intention following excision of the tracheocutaneous fistula. No large series compares the
efficacy of these techniques and each has its own merits. Recent literature has purposed to
minimizing complications. For ten years, from January 1985 to December 1994, the authors
experienced 25 cases of TCF which were analyzed in respect to incidence and interval of
cannulation, duration between decanulation and fistular closure, precedent diease, closure
methods, and complications of TCF repair.
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