Sternohyoid muscle flap interposition in the treatment of an acquired tracheoesophageal fistula

BACKGROUND: Tracheoesophageal fistula caused by prolonged intubation is a rare clinical entity. We report the case of a patient successfully treated by interposition of a sternohyoid muscle flap. METHODS: Tracheoesophageal fistula secondary to prolonged ventilatory assistance developed in a 61-year-old woman who had a septic shock related to fecal peritonitis. Fistula was located at the decubitus point of the cuffed tracheostomy tube on the posterior tracheal wall. Esophageal and tracheal defects were separately sutured and protected by interposition of a left inferiorly based sternohyoid muscle flap. RESULTS: There were neither local wound complications nor suture release and the procedure resulted in resolution of the fistula allowing a full oral diet. Sixty days after the operation, tracheal stoma was finally closed. CONCLUSION: The described approach has to be retained as an alternative to other surgical methods such as tracheal resection and major flap mobilization.