The tracheostomy-sphincter procedure - Case report of a modified tracheostomy

Background: For an adequate speech production after tracheostomy patients are dependant on a temporary closure of the stoma. This closure can either be done manually or by the use of various tracheostoma valves. The tracheostomy-sphincter procedure, which is introduced in this case, allows the voluntary constriction of the stoma. Methods: This case describes the treatment of a paediatric patient with laryngeal stenosis. During tracheostomy formation, an artificial muscle-sphincter was created, using the sternohyoid muscle (strap muscle). Results: Postoperative contractile movements were possible, which were improved by special exercises. After 3 months the complete closure of the tracheostoma was achieved. Conclusions: The establishment of a tracheostomy-sphincter can be carried out during tracheostomy and allows the patient to speak without the use of a device. Tracheobronchial secretions can be cleared via the pharynx by coughing.