Management of the Flap Tracheostomy: An Experimental Study

Lulenski, Gary C.; Batsakis, John G.

doi:10.1001/archotol.1979.00790170030008

Cited by 13 publications

(9 citation statements)

References 13 publications

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“…In contrast to previous animal studies comparing different types of tracheal incision, which showed either that the vertical incision should be the incision of choice [18] or that the inferior flap tracheostomy should be favorized [17,20], it is our opinion that the type of tracheal incision is relatively insignificant concerning the occurrence of clinically relevant postoperative tracheal stenosis.…”

Section: Discussioncontrasting

confidence: 85%

“…Vertical tracheal incision [17][18][19] and creation of inferiorly [17,18,20] or superiorly [19] based tracheal flaps in animal models have also been studied. The incidence of late complications related to the stoma or tracheal lesions such as tracheal stenosis, formation of granulation tissue, suprastomal collapse, or fatal complications could not clearly be related to the type of tracheal incision or the creation of a tracheal flap [21,22].…”

mentioning

confidence: 99%

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A single-center 6-year experience with two types of pediatric tracheostomy

Rozsasi¹,

Kühnemann²,

Gronau³

et al. 2005

International Journal of Pediatric Otorhinolaryngology

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Section: Discussioncontrasting

confidence: 85%

mentioning

confidence: 99%

A single-center 6-year experience with two types of pediatric tracheostomy

Rozsasi¹,

Kühnemann²,

Gronau³

et al. 2005

International Journal of Pediatric Otorhinolaryngology

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“…Several types of tracheostomy incisions in dogs, including transverse and vertical, U-shaped flap through two tracheal rings, and excision of 1 cm segments of 1 and 2 rings have been compared [5,6,8,16,17,22]. Vertical tracheostomy shows the most consistent healing [5,6].…”

Section: Stomal Complicationsmentioning

confidence: 99%

“…Surgical procedures in canines have been described for permanent tracheostomy [13][14][15][16][17]. The literature present different surgical approaches with much contention concerning direction and type of incision, location of stoma placement, and merit of cartilage excision [5,6,8,16,17].…”

Section: Introductionmentioning

confidence: 99%

“…The literature present different surgical approaches with much contention concerning direction and type of incision, location of stoma placement, and merit of cartilage excision [5,6,8,16,17]. However, most studies were designed to look at short-term changes in tracheal structure over a period of weeks or months and do not consider longerterm stoma viability.…”

Section: Introductionmentioning

confidence: 99%

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Permanent Tracheostomy for Long-Term Respiratory Studies

Bartoli¹,

Akiyama²,

Okabe

et al. 2008

Journal of Surgical Research

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Laryngeal reconstruction following vertical partial laryngectomy

Burgess

1993

The Laryngoscope

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Laryngeal reconstruction following vertical partial laryngectomy (VPL) with arytenoidectomy was studied in 30 dogs. Variations of a superiorly based thyroid cartilage flap (TCF) were used for reconstruction. In addition, sternohyoid muscle reconstruction and endolaryngeal muscle coverage were studied. Larynges were recovered after a 6-month period in 28 surviving dogs and were analyzed by endoscopic photographs and axial whole-organ sections. Endoscopic assessment (n = 18) demonstrated good results for arytenoid replacement (100%), pseudocord position (94%), pseudocord development (94%), and airway patency (100%). Arytenoid replacement was judged as completely (78%) or partially (22%) replaced. This was accomplished by a pseudocord extending to the cricoid in the horizontal plane. Pseudocord position was judged as normal (83%) or paramedian (11%), with the remainder lateralized (6%). Pseudocord development was judged as complete (72%) or partial (22%), with the remainder poor (6%). Reviewing both endoscopic photographs and gross sections (n = 28), airways were all normal without laryngeal or tracheal stenosis. Histologic assessment (n = 24) also demonstrated good results for arytenoid replacement (79%), pseudocord position (87%), and TCF survival in the glottic plane (79%). Arytenoid replacement was judged as complete (62%) or partial (17%), with the remainder poor (21%). Pseudocord position was judged as normal (50%) or paramedian (37%), with the remainder lateralized (13%). TCF survival was judged as total (63%) or partial (16%). Although not present in the glottic plane in the remaining cases (21%), a portion of the TCF was always present in the supraglottic region. The TCF was largely replaced by bone in the region of the pseudocord, and was covered by nonkeratinizing stratified squamous epithelium and a thick fibrous layer. Breakdown over the TCF was infrequent, with a small focus of granulation tissue over cartilage present in 1 (4%) of 24 cases. Clinically insignificant granulation tissue was present in a total of 6 (25%) cases. In the other 5 cases, this was over muscle or over permanent sutures. Focal cartilage necrosis was present in 2 (8%) of 24 cases, and was localized, self limiting, and deep to the endolaryngeal surface. When the TCF failed to survive histologically, poorer results for arytenoid replacement and pseudocord position generally resulted. However, this apparent difference was not statistically significant due to small sample sizes and variability in results. Other factors that may have kept this difference from becoming larger were thought to be contraction of th e normal cord towards the operated side with fore-shortening of the glottis, and medial rotation and ossification of the posterior thyroid ala remnant.(ABSTRACT TRUNCATED AT 400 WORDS)

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Management of the Flap Tracheostomy: An Experimental Study

Cited by 13 publications

References 13 publications

A single-center 6-year experience with two types of pediatric tracheostomy

A single-center 6-year experience with two types of pediatric tracheostomy

Permanent Tracheostomy for Long-Term Respiratory Studies

Laryngeal reconstruction following vertical partial laryngectomy

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