Tracheostomy scar revision

Tracheostomy tube placement is a common procedure performed in patients with severe maxillofacial trauma. Many patients that do not require emergent intubation will require an elective tracheostomy at the time of maxillomandibular fixation and fracture repair due to oropharyngeal edema. After recovery and decanulation, these patients often have a resulting tracheostomy scar that is hypertrophy and discolored. The scar may be adherent (or tethered) to the underlying trachea which can be uncomfortable during swallowing. The objectives of surgical revision of a tracheostomy scar are to improve the appearance and symptoms of tracheocutaneous tethering. A variety of standard scar revision techniques are employed to fill the depressed scar and to separate the skin from the tracheal scar with mobilized strap muscles or grafting material, such as cadaveric acellular dermis.