Resection of the cervical trachea: a different incision?

Excision of the entire trachea at laryngectomy may make it impossible to suture retrosternal tracheal circumference to skin without tension if traditional skin incisions are used. A satisfactory and possibly original approach to this problem is described with two illustrative case histories. The incision described using a laterally based skin flap allows adjacent skin to be drawn into the neck and any resulting defect is closed with partial thickness skin. The advantages of such a flap over traditional incisions are discussed.