Analysis of tracheostoma morphology

Abstract

Objectives: Existing fixation methods of automatic speaking valves (ASVs) suffer from shortcomings which partly are the result of insufficient conformity of the intratracheal fixation method’s shape to the tracheostoma anatomy. However, quantitative data are lacking and will be helpful to analyse solutions for airtight fixation. This article provides such data.

Patients and methods: The tracheostoma morphology was measured in computerized tomography scans of 20 laryngectomized patients. Measured were transverse and sagittal diameters, transition angle between skin level and tracheostoma lumen and between the tracheostoma lumen to the trachea, TE valve placement and stoma depth.

Results: The mean transverse and sagittal diameters of the stoma at the peristomal lip are 19.2 mm [standard deviation (SD 5.2 mm)] and 17.6 mm (SD 5.3 mm), respectively. The mean transition angles are 84.5° (SD 15.6°) at skin level and 153.6° (SD 11.7°) into the trachea. The mean distance between TE valve and peristomal lip is 13.5 mm (SD 7.0 mm). The mean stoma depth is 14.0 mm (SD 6.4 mm).

Conclusions: Due to the large variation, no ‘average tracheostoma morphology’, suitable for shaping a generic intratracheal fixation device, can be defined. Therefore, providing an airtight fixation in each patient would require a large range of different sizes, customization or a new approach.

Chinese abstract

目的：现有的自动口腔阀（ASV）的固定装置存在缺陷, 部分原因是气管内固定装置的形状与气管切开解剖特征不够吻合。然而, 定量数据缺乏, 这种数据将有助于分析气密固定的解决方案。本文提供了这样的数据。

患者和方法：在20例喉切除患者的计算机断层扫描中测量气管瘤形态。经测量的是横向和矢状直径、皮肤层面与气管腔内腔之间以及气管内腔与气管之间的转换角度、TE阀位置和造口深度。

结果：腹膜周围的气孔的平均横向和矢状径分别为19.2 mm（标准偏差（SD 5.2 mm））和17.6 mm（SD 5.3 mm）。平均过渡角在皮肤层面为84.5°（SD 15.6°）, 在气管内为153.6°（SD 11.7°）。 TE阀和周围唇缘之间的平均距离为13.5 mm（SD 7.0 mm）。平均造口深度为14.0mm（SD 6.4mm）。

结论：由于变异度大, 无法确定”平均气管瘤形态”, 来制作一般性的气管内固定装置。因此, 为每个患者提供气密固定装置将需要大量的不同尺寸、量身定制或一种新方法。

Keywords:

• Total laryngectomy
• tracheostoma anatomy
• tracheostoma geometry
• tracheostoma morphology
• automatic speaking valve
• heat-and-moisture exchange filter
• intratracheal fixation
• customized fixation

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.