Myotomy of sternocleidomastoid muscle as a secondary procedure in laryngectomized patients.

Abstract

The application of specific devices to seal the tracheal stoma in laryngectomized patients is critical for optimal pulmonary and phonatory rehabilitation. Indeed, an excessive stomal depth is one of the main causes of rehabilitation failure. In this context, division of the sternal heads of the sternocleidomastoid muscle (SCM) is a common technique, usually performed during the laryngectomy. We perform a myotomy of the sternal head of the SCM in deep and narrow tracheal stoma as a secondary procedure under local anesthesia, and here we describe the surgical steps of this procedure. The medium depth of the stoma is reduced, and no procedure-specific complications have been observed. Postoperative morphological features show a flattening of the peristomal area, and all patients have begun regular use of appropriate patches and filters. Secondary section of SCM is a safe, simple, and effective procedure in total laryngectomies with deep and narrow stoma.