Design of a new technique using a free tracheal autologous graft for reconstruction of the cricoid cartilage and trachea.

PURPOSE

We devised a new operative procedure to recreate a supporting framework using a free tracheal autologous graft for cricoidal and tracheal defects.

METHODS

We used this new transplantation method to repair the airway defect in five patients who underwent total thyroidectomy with resection of the airway for advanced thyroid cancer. A free graft was taken from the anterior aspect of the trachea and placed over the defect. The surface of the transplanted graft was then surrounded by the adjoining muscle flap. The orifice created by taking the graft was used as a temporary tracheostomy during the early postoperative period.

RESULTS

Fiberscopic examinations and computed tomography scans done over 3-7 years postoperatively showed no airway deformity, subglottic stenosis, graft necrosis, or local recurrence in any of the five patients. The tracheal stoma closed spontaneously within 5 months after the operation in three of the five patients.

CONCLUSION

The advantages of this procedure are: the free tracheal graft has as much strength as a prosthesis to support the respiratory tract; the autologous graft is biologically compatible; and the procedure can be completed in one surgical field and adopted for primary and secondary repair of the tracheal defect.