J Indian Prosthodont Soc. 2015 Jan-Mar;15(1):76-82. doi: 10.4103/0972-4052.155047.

A new and simple method of fabrication of tracheostomal prosthesis.

Journal of Indian Prosthodontic Society

N Vidya Sankari, Jayashree Mohan, Paul Simon, Indumathi Sivakumar, Yogesh Subamanium

PMID: 26929491 PMCID: PMC4762288 DOI: 10.4103/0972-4052.155047

Abstract

Patients with a tracheostomy stoma experience compromised speech and function due to the associated changes in airflow patterns. Rehabilitation of a patient with tracheal stoma is a highly challenging task. The main objective is to design an inexpensive, easily fabricated stomal prosthesis for postlaryngectomy patients who require prolonged tracheotomy. This clinical case report describes a 29-year-old male patient who underwent for tracheotomy 3 months before for respiratory distress following a suicidal attempt. Hence tracheotomy was done, and the patient has been with the tracheostomal tube since surgery for the past 3 months. Laryngoscopy examination reported as restricted bilateral vocal cord movements, and the cords were in the adducted position with minimal glottic chink. No history of difficulty in swallowing. On examination, no scar or ulceration is seen around the stoma. The skin around the stoma is healthy. The patient was referred to the oral and maxillofacial Prosthodontics Department from the Department of ENT. The patient's old tracheostomal tube was used as the dimensions of the custom made tracheal prosthesis without making a functional impression of the mature stoma. A tracheal button was made with 2 mm polyethylene urethane sheet to maintain the airway patency of the mature stoma. Width and length of the old tracheostomal tube were measured and customized with polyurethane sheet by directly flaming over heat. The finished product was thin, flexible, maintains enhanced tear strength, require no tapes or adhesives and less technique sensitive. These properties of the prosthesis make more advantageous than the commercially available tracheal buttons. The result in this patient was excellent with no postoperative complications. An innovative approach for fabrication of tracheostomal prosthesis was discussed to increase its successful use in tracheostomal patients. The patient's old tracheostomal tube was used as the dimensions of the custom made tracheal prosthesis without making a functional impression of the mature stoma. The finished product was thin, flexible, maintains enhanced tear strength, require no tapes or adhesives and less technique sensitive. These properties of the prosthesis makes more advantageous than the commercially available tracheal buttons. The result in this patient was excellent with no postoperative complications.

Keywords: Poly ethylene urethane sheet; tracheal button; tracheal stoma; tracheotomy

References

1. J Prosthet Dent. 1987 Feb;57(2):208-14 - PubMed
2. Arch Otolaryngol. 1981 Nov;107(11):670-3 - PubMed
3. Plast Reconstr Surg. 1982 Dec;70(6):694-8 - PubMed
4. Otolaryngol Head Neck Surg. 1988 Jul;99(1):38-41 - PubMed
5. J Prosthet Dent. 2000 May;83(5):578-81 - PubMed
6. J Prosthodont. 2003 Mar;12(1):17-20 - PubMed
7. J Prosthet Dent. 1990 Feb;63(2):182-6 - PubMed
8. J Laryngol Otol. 2003 May;117(5):365-7 - PubMed
9. Int J Prosthodont. 1993 Jan-Feb;6(1):65-70 - PubMed
10. Int J Pediatr Otorhinolaryngol. 2013 May;77(5):623-8 - PubMed
11. Otolaryngol Head Neck Surg. 1995 Sep;113(3):242-7 - PubMed
12. J Prosthet Dent. 1969 Jul;22(1):84-7 - PubMed
13. Laryngoscope. 2011 Mar;121(3):583-4 - PubMed
14. Laryngoscope. 1994 Jan;104(1 Pt 1):59-63 - PubMed
15. J Prosthet Dent. 1991 Aug;66(2):231-3 - PubMed
16. Eur Arch Otorhinolaryngol. 2013 Nov;270(12):3187-9 - PubMed
17. Otolaryngol Clin North Am. 1983 May;16(2):391-405 - PubMed
18. Otolaryngol Head Neck Surg. 2002 Jul;127(1):122-3 - PubMed

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• Case Reports