Ishikawa K, Isshiki N
Department of Plastic Surgery, Kyoto University School of Medicine, Japan.
Br J Plast Surg. 1988 Nov;41(6):652-6. doi: 10.1016/0007-1226(88)90177-4.
A case of tracheal stenosis was reconstructed, after trough formation, with a chondromucosal flap which was developed by submucous perichondrial grafting. At the first stage, a free perichondrial graft from the pinna was transplanted into the buccal submucosal layer. About 10 months later, when sufficient neocartilage had formed, the chondromucosal composite graft was transferred from the buccal region to the paratracheal subcutaneous region with the mucosa facing deeply. Finally, 4 weeks later the tracheal trough was closed with a composite rotation flap which incorporated the skin, neocartilage and mucosa. The postoperative course was uneventful and a wide tracheal lumen with a firm framework and mucous lining was confirmed by both fibrescopic and radiographic examination.
一例气管狭窄患者在形成沟状结构后,采用经黏膜下软骨膜移植形成的软骨黏膜瓣进行重建。第一阶段,将取自耳廓的游离软骨膜移植到颊黏膜下层。约10个月后,当形成足够的新软骨时,将软骨黏膜复合移植瓣从颊部区域转移至气管旁皮下区域,黏膜面朝向深部。最后,4周后用包含皮肤、新软骨和黏膜的复合旋转瓣封闭气管沟。术后过程顺利,纤维镜和影像学检查均证实气管腔宽大,有坚实的支架结构和黏膜衬里。