Invited Commentary The Annals of Thoracic Surgery James R. Stewart, MD The Annals of Thoracic Surgery Volume 99, Issue 2, Pages 453-454 (February 2015) DOI: 10.1016/j.athoracsur.2014.10.083 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions
Fig 1 Evolution of stomal stenosis is shown in cross-sectional diagrams of the trachea at the stomal site. (A) The tracheostomy tube may be leveraged against the stomal margins, causing their erosion. (B) The resulting large stoma exhibits granulations and inflammation at its margins. (C) Contraction of scar tissue forming across the defect pulls the tracheal stomal margins to the midline. (D) The result is an A-shaped lumen. The posterior wall is also often shortened. Scar tissue is present, in more anteriorly only. Taken from Hermes C. Grillo, Surgery of the Trachea and Bronchi. Illustrations by Edith Tagrin. Shelton, CT: PMPH-USA, Ltd. Used with permission from the People’s Medical Publishing House-USA. The Annals of Thoracic Surgery 2015 99, 453-454DOI: (10.1016/j.athoracsur.2014.10.083) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions