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Vascularized composite autograft for adult laryngotracheal stenosis and reconstruction
Author(s) -
Rich Jason T.,
Goldstein David,
Haerle Stephan K.,
Busato GianMarco,
Gullane Patrick J.,
Gilbert Ralph W.
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23887
Subject(s) - laryngotracheal stenosis , stenosis , composite number , medicine , surgery , anatomy , tracheal stenosis , radiology , materials science , composite material
Background Adult laryngotracheal reconstruction for airway stenosis and after oncologic ablation can be extremely challenging. Methods Patients with the above conditions not amenable to or refractory to conventional treatments were offered specialized reconstruction by wrapping a contoured costal cartilage graft with a vascularized microvascular carrier. All constructs were lined with buccal mucosa grafts. Decannulation rates, quality of life questionnaires, and pulmonary function tests were performed and analyzed. Results Eleven patients underwent this procedure, 6 for stenosis and 5 for laryngotracheal oncologic defects. Ten patients were successfully decannulated after the procedure (91%). Median time to decannulation was 4 months. At mean follow‐up of 76 months, all evaluated patients had a serviceable voice, tolerated a normal diet, and had minimal subjective shortness of breath. Conclusion Vascularized composite autograft can be successfully used to treat severe subglottic stenosis or reconstruct large laryngotracheal defects not amenable to or refractory to conventional treatments. © 2014 Wiley Periodicals, Inc. Head Neck 38: 253–259, 2016