Myotomy of sternocleidomastoid muscle as a secondary procedure in laryngectomized patients

Giovanni Paolo Santoro MD  Paolo Luparello MD  Maria Silvia Lazio MD  Lara Valentina Comini MD Federica Martelli MD  Angelo Cannavicci MD
First published: 26 July 2019 https://doi.org/10.1002/hed.25852
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Abstract
Background
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.

Methods
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.

Results
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.

Conclusions
Secondary section of SCM is a safe, simple, and effective procedure in total laryngectomies with deep and narrow stoma.