Advantages of the Rotary Door Flap in Laryngotracheal Reconstruction: Is Skeletal Support Necessary?

Eliachar, Isaac; Welker, Keith B.; Roberts, Jay K.; Tucker, Harvey M.

doi:10.1177/000348948909800108

Cited by 47 publications

(17 citation statements)

References 8 publications

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“…Moreover, other interposition procedures have been proposed: free grafts [3,10,17,18,21,24], including the septal cartilage, auricular cartilage, thyroid cartilage, hyoid bone, rib, clavicle, and iliac crest; ands pedicle grafts or flaps such as the myocutaneous rotation flap [4,5], the muscle-cartilage flap, and the pectoralis major myocutaneous flap [7].…”

Section: Introductionmentioning

confidence: 99%

Composite hyoid-sternohyoid interposition graft in the surgical treatment of laryngotracheal stenosis

Keghian¹,

Lawson²,

Orban³

et al. 2000

European Archives of Oto-Rhino-Laryngology

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This article reports six patients with severe laryngotracheal stenosis. The causes of stenosis were tracheotomy (two cases); prolonged endotracheal intubation (one case); laryngeal trauma (two cases); and surgery with postoperative chemo- and radiotherapy, addressing a thyroid gland follicular adenocarcinoma (one case). Two patients were already tracheotomized. The main postoperative complication was necrosis of the graft in a female patient who had previously undergone treatment for thyroid follicular adenocarcinoma. All patients were decannulated 6 months postoperatively. Five patients were then regularly followed up, but we lost contact with one patient. Comparison between pre- and postoperative pulmonary function testing revealed an increased maximum inspiratory flow (Vi max50) in five cases between 0.57 l/s and 2.18 l/s. A helical scan with 3-dimensional reconstruction of the cervical area in four patients confirmed the presence and preservation of the hyoid bone graft. Four patients remained satisfied with their postoperative voice quality, one patient was dissatisfied, and one patient was not followed up. This technique is effective in adults with severe laryngotracheal stenosis, restricted to the first tracheal rings, providing one takes into consideration the main contraindications of the procedure: past history of radiotherapy and thyroid surgery.

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Section: Introductionmentioning

confidence: 99%

Composite hyoid-sternohyoid interposition graft in the surgical treatment of laryngotracheal stenosis

Keghian¹,

Lawson²,

Orban³

et al. 2000

European Archives of Oto-Rhino-Laryngology

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“…6 If a patient's lesion is too extensive and not amenable to segmental resection and anastomosis in combination with the release maneuvers described above, skin-inversion reconstruction procedures can be used. 9,10 In the case reported herein, the patient had a 6-cmlong area of circumferential stenosis of the subglottic and cervical trachea. She subsequently underwent resection of the lesion with primary anastomosis using annular ligament release, suprahyoid release, and neck flexion to obtain a tension-free anastomosis.…”

Section: 2mentioning

confidence: 81%

Radiology Quiz Case

Le¹,

Hardeman²,

Kokoska³

2002

Arch Otolaryngol Head Neck Surg

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A 36-YEAR-OLD WOMAN with diabetes presented with an acute worsening of progressive dyspnea on exertion that had required multiple visits to a local emergency department over the prior month. Her primary care physician had treated her with increasing doses of asthma medications, which had failed to relieve her symptoms. Her medical history was significant for an episode of bacterial meningitis 2 months earlier, for which she had undergone 4 days of intubation and mechanical ventilation. On admission, she had a weak, breathy voice and biphasic stridor that was worse with talking and exertion, and arterial blood gas analysis revealed that her oxygen saturations were 95% on room air, with a CO 2 of 59 mm Hg. A lateral airway film was inconclusive. Flexible nasopharyngoscopy revealed a subglottic soft tissue obstruction. An urgent tracheostomy was performed while the patient was fully conscious. Views of the glottis and subglottis as seen on direct laryngoscopy are shown in Figure 1 and Figure 2, respectively. A sagittal reformat of a 3-mm axial computed tomographic scan of the neck obtained after the tracheostomy is shown in Figure 3; a 7.0-mm endotracheal tube is in place in the trachea.

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“…Eliachar ve ark. ön komissürden subglottik yayılmanın aşırı olduğu durumlarda rezeksiyona krikoit kartilaj ön segmentiyle bir ya da ikinci trakeal halka ön bölümlerini dahil ederek, oluşan defekti epiglottik larengoplasti ve rotary-door flep yön-temiyle rekonstrükte ettiklerini bildirmişlerdir (48,49). Benzer durumlarda NSK, yeterli ve güvenilir bir rekonstrüksiyon materyalidir (41).…”

Section: Discussionunclassified

Larengotrakeal Rekonstrüksiyonda Kompozit Nazal Septal Kartilaj Kullanımı / Nasal Septal Cartilage Composite Graft Use in Laryngotracheal Reconstruction

Cansız

Yener

2016

Anadolu Klin

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ÖzetLarengotrakeal rekonstrüksiyon (LTR) baş-boyun cerrahlarının gerçekleştirdiği en zorlu prosedürlerden biri olmaya devam etmektedir. Larengotrakeal stenoz (LTS) vakalarında açık ya da kapalı birçok teknik uygulanmaktayken, larengeal tümörlerde tümörün mikrocerrahiyle çıkarıl-masından subtotal larenjektomiye kadar birçok konservatif seçenek mevcuttur. Ancak bu tip hastaların tedavisinde tek bir yöntem yoktur ve cerrahın uygun hastada uygun metodu uygulaması gerekmektedir. Bu yazıda; cerrahi, travma, tümör ya da larengotrakeal stenoz gibi lezyonlarda /defektlerde kompozit nazal septal kıkırdak kullanımı ile ilgili teknik bilgi, endikasyonlar ve deneyimimiz sunulacaktır. Anahtar Kelimeler: larengeal tümörler; trakeal tümörler; nazal septal kıkırdak grefti; larengotrakeal defekt; lateral rezeksiyon. AbstractLaryngotracheal reconstruction still remains as one of the most challenging procedures in otolaryngology practice. A variety of reconstruction materials and methods are used to repair laryngotracheal defects. No single surgical procedure exists that is appropriate for all situations, and the surgeon has to make a choice among these methods. This article describes the technical data on, the indications of, and our experience with the use of composite nasal septal cartilage graft for the reconstruction of laryngotracheal defects.

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Advantages of the Rotary Door Flap in Laryngotracheal Reconstruction: Is Skeletal Support Necessary?

Cited by 47 publications

References 8 publications

Composite hyoid-sternohyoid interposition graft in the surgical treatment of laryngotracheal stenosis

Composite hyoid-sternohyoid interposition graft in the surgical treatment of laryngotracheal stenosis

Radiology Quiz Case

Larengotrakeal Rekonstrüksiyonda Kompozit Nazal Septal Kartilaj Kullanımı / Nasal Septal Cartilage Composite Graft Use in Laryngotracheal Reconstruction

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