Experimental laryngeal reconstruction with preformed composite graft.

The use of perichondrial grafts for reconstruction of the thyroid cartilage of the larynx was studied in two series of rabbits. In the first pilot study the thyroid cartilage was replaced by a cartilage performed by the neochondrogenic effect of an auricular perichondrial graft set into the defect on a subcutaneous flap. When this transplantation technique proved successful, another series was performed where a laryngeal defect of the thyroid cartilage and the underlying mucosa were replaced by a preformed composite graft. This composite graft consisted of a biological support of newly formed cartilage from the neochondrogenic effect of a free perichondrial graft and mucosal lining made of a retention cyst from a free graft of oral mucosa. The newly formed composite graft was transferred to set into the laryngeal defect on a subcutaneous flap. The reconstruction was successful and all the rabbits survived, with no respiratory distress. The newly formed cartilage offered sufficient support to the reconstructed larynx. The lining formed from the mucosa of the retention cyst consisted of undiffered stratified squamous cells. This lining membrane was sufficient to control the fibrous tissue response and maintain patency of the restored lumen.