| [Successful treatment of subglottic tracheal stenosis with a mucosa-lined radial forearm fascia flap]. | |
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MedLine Citation:
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PMID: 23202872 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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M Mandapathil; T K Hoffmann; L Freitag; N Reddy; S Lang; P Delaere |
Publication Detail:
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Type: English Abstract; Journal Article |
Journal Detail:
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Title: HNO Volume: 60 ISSN: 1433-0458 ISO Abbreviation: HNO Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-03 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 2985099R Medline TA: HNO Country: Germany |
Other Details:
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Languages: ger Pagination: 1131-5 Citation Subset: IM |
Affiliation:
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Klinik für Hals-Nasen-Ohren-Heilkunde, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland, magis.mandapathil@uk-essen.de. |
Vernacular Title:
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Erfolgreiche Behandlung einer subglottischen Trachealstenose mittels Mukosa-Radialisfaszien-Lappen. |
Export Citation:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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