Document Detail


Tracheal neovascularization: a method involving mobilization of a complete tracheal neovascularized segment using a sternohyoid muscle flap.
MedLine Citation:
PMID:  8544634     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Tracheal segmental free grafts always tend to undergo necrosis with consequent occlusion of the airway. Revascularized grafts are impossible to carry out, since the trachea is devoid of a major vascular pedicle that would permit microvascular reconstruction. On the other hand, neovascularized grafts carry a potential for success but have not been sufficiently studied. Neovascularization of a six-ring circumferential tracheal segment (CTS) was studied in dogs using a sternohyoid muscle (SM) flap. Three different procedures were carried out. In group 1 the six-ring CTS was inside a free graft. In group 2 the SM was freed from its proximal connection and rotated to wrap a corresponding six-ring CTS; it was then sutured and left in place for 21 days. After this period it was again approached, and the six-ring CTS was sectioned and sutured back in place, leaving the distally pedicled SM untouched. In group 3 an identical procedure was carried out, but the SM flap was left with a proximally rather than a distally based flap. All surviving animals were followed up for at least 1 year, and the results were analyzed by clinical and tracheoscopic observations and by macroscopic and microscopic studies after the animals were killed. All animals in group 1 died within 18 days; the studies showed necrosis and occlusion of the CTS. In groups 2 and 3 there was no degenerative change of the CTS, whose aspect was close to normal on macroscopic and microscopic examination. We conclude that the free CTS graft is totally inviable. In contrast, neovascularization of the CTS occurs when the segment is first wrapped around with an SM flap. This ensures CTS viability and opens new perspectives for homotransplantation.
Authors:
F V de Mello-Filho; R C Mamede; M A Velludo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Laryngoscope     Volume:  106     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-02-13     Completed Date:  1996-02-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  81-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, Orthopedics and Traumatology, University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Animals
Dogs
Female
Hyoid Bone
Male
Methods
Muscles*
Neovascularization, Physiologic*
Sternum
Surgical Flaps*
Trachea / blood supply*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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