Experimental Repair of Subglottic Stenosis in Piglets: "Trapdoor" Thyrochondroplasty Flap

The history of pediatric airway reconstruction

“…Building upon Lapidot's experience with thyrochondrial rotational flaps,41 Cotton and Fearon began their surgical experimentation on green monkeys due to their anatomic similarities to the infant larynx. They reported success in enlarging the lumen and were hopeful of translating their work to children with subglottic stenosis 40.…”

Comparison of Thyroid, Auricular, and Costal Cartilage Donor Sites for Laryngotracheal Reconstruction in an Animal Model

“…Early methods, pioneered by Rethi 1 in 1956, focused on splitting the cartilaginous skeleton. In 1969, Lapidot et al 2 reported on a method of repairing subglottic stenosis in piglets that used an interposition technique. Fearon and Cotton [3][4][5] extended the experimental work of Lapidot et al and popularized the method of anteriorly splitting the thyrocricoid complex and placing autogenous graft material in children.…”

The Problem of Pediatric Laryngotracheal Stenosis: A Clinical and Experimental Study on the Efficacy of Autogenous Cartilaginous Grafts Placed Between the Vertically Divided Halves of the Posterior Lamina of the Cricoid Cartilage

“…95 None of this work, however, involved children or growing animals. Lapidot, et al (1968) 96 successfully demonstrated an experimental repair of subglottic stenosis in piglets using a "trapdoor" thyrochondroplasty flap. The stimulus for that work was given, "We have been unable to find a report in the literature which describes a method for reconstruction and subsequent decannulation in the infant or the child in his first decade of life with subglottic stenosis."…”

“…The experimental work of Lapidot, et al was of considerable significance as a step in questioning this concept. 96 Cartilaginous grafts have long been used in humans. Bert was the first to use autogenous grafts experimentally in 1865, 97 but the first serious interest in the biology of grafted cartilage began in the 1930s with the work of Peer, who showed that the chondrocytes of transplanted cartilage remain viable in the host, and that the matrix remains unchanged and is maintained by those cells.…”