Immediate tracheal reconstruction with forearm flap and bone graft

Microsurgery
Tateki KuboKo Hosokawa

Abstract

"Window" resection of the trachea is sometimes performed to remove tumors invading the trachea. Here, we present a novel reconstructive procedure to this end. Eleven patients (mean age, 64 years; range, 46-80 years) were included. Primary diagnoses included thyroid cancer and adenoid cystic carcinoma of the trachea. All defects were partial and located in the neck (mean width and length, 3/5 circle and 7.5 rings; range, 1/2-2/3 circle and 5-9 rings). Immediate 2-stage reconstruction was performed using a forearm flap and free bone graft. The bone graft was utilized as a supportive skeleton. A tracheostoma was left open for several months following the initial surgery, and then closed. The mean flap size was 6.1 × 9.7 cm (range, 6-7 × 7-16 cm). Mean number of grafted bone strips and length were 1.6 (range, 1-3) and 6.1 cm (range, 4.5-7 cm). All flaps survived. Five patients developed complications in the neck, including surgical site infections (SSIs), recurrent nerve palsy, and lymphorrhea. Four patients developed donor site complications, including clavicular fracture and SSIs. Mean postoperative follow-up lasted 85 months (range, 11-149 months). Normal speech was restored in 9 patients. Stoma closure was abandoned in 2 patien...Continue Reading

References

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Citations

Sep 29, 2020·The Laryngoscope·Meredith AllenPeter F Svider
Oct 27, 2020·Current Opinion in Organ Transplantation·Jan Jeroen Vranckx, Pierre Delaere
Nov 3, 2020·Laryngoscope Investigative Otolaryngology·Bianca LorntzsenTerje Osnes

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