Document Detail


[Successful treatment of subglottic tracheal stenosis with a mucosa-lined radial forearm fascia flap].
MedLine Citation:
PMID:  23202872     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Short-segment tracheal stenosis is often treated by segmental resection and end-to-end anastomosis. Longer-segment stenosis can sometimes be treated using dilation, laser therapy, bronchoscopic stent insertion and segmental resection and reconstruction. Long-segment restenosis with a buildup of scar tissue due to successful resection surgery in the past represents a particular therapeutic challenge and a sufficiently vascularized transplant may be the only option. We describe the case of a 37-year-old patient who underwent a tracheal reconstruction using a mucosa-lined radial forearm flap. Subsequent to a traumatic laryngotracheal fracture, long-term ventilation and multiple surgical interventions, the patient had developed a functionally relevant subglottic stenosis (5.5 cm). Following longitudinal anterior resection of the trachea 1 cm above and below the stenosis, a Dumon® stent was inserted. Simultaneously, a radial forearm fascia flap was harvested, as were two full-thickness buccal mucosa grafts, which were sutured onto the subcutaneous tissue and fascia of the forearm flap. Beginning caudally, the mucosa-lined flap was then sutured, air-tight, into the anterior tracheal defect with the mucosa facing the lumen. Finally, end-to-end anastomosis connected the blood vessels of the radial forearm flap to the recipient blood vessels in the neck. The patient was successfully extubated after 24 h and discharged after 5 days. A postoperative CT scan revealed optimal placement of the stent and the patient's speech and breathing were sufficiently re-established. The stent was removed bronchoscopically 6 weeks after surgery. Examinations during the 6-month follow-up period showed that the diameter of the reconstructed airway was retained and the patient remained symptom-free.
Authors:
M Mandapathil; T K Hoffmann; L Freitag; N Reddy; S Lang; P Delaere
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  HNO     Volume:  60     ISSN:  1433-0458     ISO Abbreviation:  HNO     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985099R     Medline TA:  HNO     Country:  Germany    
Other Details:
Languages:  ger     Pagination:  1131-5     Citation Subset:  IM    
Affiliation:
Klinik für Hals-Nasen-Ohren-Heilkunde, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland, magis.mandapathil@uk-essen.de.
Vernacular Title:
Erfolgreiche Behandlung einer subglottischen Trachealstenose mittels Mukosa-Radialisfaszien-Lappen.
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