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Abstract: The basic principie in the surgical technique adopted to treat cicatricial tracheostomal stenosis, following total laryngectomy, is the ínterposition of a V skin flap, by Y - V advancement or rotation, in the posterior tracheal wall. The V flap increases the tracheal circumference and redirects the constricting circular scar of the tracheostome, preventing restenosis. This prospective study presents the Results of this technique in 14 patients with tracheostome stenosis, treated from 1980 to 1996. Results from this technique have been gratifying. The tracheostome remains stable immediately following reconstruction (tracheal cannula is not required) and does not demonstrate restenosis over extended followup periods, with minimum follow-up of one gear. This technique is a simple procedure, has low morbidity, may be performed in all stenosed stoma configurations, and also in tracheostome construction at the time of total laryngectomy. The viabiliry of the V skin flap is not affected by radiotherapy (71% of patients), either before or after tracheostome reconstruction.
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