Microvascular cricoid cartilage reconstruction with the thoracodorsal artery scapular tip autogenous transplant

Abstract

Conservation laryngeal surgery has been limited by difficulties with partial resection of the cricoid. Numerous options have been suggested that include temporoparietal flaps, free cartilage grafts, radial forearm free tissue transfers, and tracheal autotransplantation with vascular carriers. The authors present a one-stage procedure for the reconstruction of the cricoid cartilage based on the thoracodorsal artery scapular tip (Tdast) autogenous transplant that uses the curved tip of the scapula and does not create a secondary tracheal defect. Because the Tdast is a vascularized graft it may withstand radiation treatment.

Rotational thyrotracheopexy after cricoidectomy for low‐grade laryngeal chrondrosarcoma

“…For the reconstruction of the airway after partial cricoidectomy, several autologous graft materials have been published. Thyroid cartilage, rib cartilage, rotated epiglottic cartilage, scapular tip, and a hyoidsternohyoid osteomuscular flap can be used to reestablish the posterior wall of the larynx . Delaere et al published a case of a cricoid chondrosarcoma treated with a vertical hemicricoidectomy, followed by a complex two‐step tracheal autotransplantation procedure .…”

“…Thyroid cartilage, rib cartilage, rotated epiglottic cartilage, scapular tip, and a hyoidsternohyoid osteomuscular flap can be used to reestablish the posterior wall of the larynx. 26,27 Delaere et al published a case of a cricoid chondrosarcoma treated with a vertical hemicricoidectomy, followed by a complex two-step tracheal autotransplantation procedure. 28 However, the need for total cricoidectomy takes the problem of the airway reconstruction to a higher level.…”

The reconstruction of large laryngeal defect with medial condyle femur corticoperiosteal free flap—a case report

“…An interesting reconstruction of the cricoid was proposed by Chanowski. He used the vascularized tip of the scapula with a buccal mucosal graft . Laryngotracheal reconstruction without microsurgery techniques was proposed by Sprecher, using bioabsorbable miniplates .…”

“…He used the vascularized tip of the scapula with a buccal mucosal graft. 23 Laryngotracheal reconstruction without microsurgery techniques was proposed by Sprecher, using bioabsorbable miniplates. 24 Laryngeal reconstruction methods with microsurgery techniques allow to a large loss to be complemented by the saving of most of the laryngeal functions.…”

Complex adult laryngotracheal reconstruction with a prefabricated flap: A case series

“…Cricoid cartilage reconstruction is particularly complex and several reconstructive techniques have been reported (Table ) . Yu et al described the use of large tracheal defects including cricoid cartilage defects using radial forearm free flaps with semirigid prosthetic grafts and pedicled muscle flaps in patients with recurrent papillary thyroid carcinoma who had undergone multiple neck surgeries.…”