Closure of Large Tracheocutaneous Fistula Using Modified Hinge Flap and Deltopectral Flap.

Abstract

Various methods for closing tracheocutaneous fistulas have been reported; however, there is no established consensus. This study reports the successful closure of a large tracheocutaneous fistula using a Modified Hinge Flap and DP flap. Between July 2014 and December 2023, four patients underwent a modified hinge flap and DP flap for tracheocutaneous fistula at a single center. The maximum diameter of the fistula was 10-33 mm, the cartilage defect was 1/4-1/2 of the total circumference of the trachea, and no radiation was administered to the neck during the perioperative period. In all cases, postoperative speech and swallowing improved, and none of the patients complained of cosmetic appearance. The method in this study is simple and allows reliable closure of relatively large tracheocutaneous fistula of 10 mm or more, and we believe that it can be a new treatment method for tracheocutaneous fistula closure.