Perichondrial Microvascular Free Transfer: Creation of a Compound Flap for Laryngeal Reconstruction in Rabbits

Abstract

A free revascularized compound perichondrial flap was used over an intralaryngeally placed stent for reconstruction of a frontal laryngeal defect. The microvascular flap replaced the cartilaginous and mucosal defect. Short-term results showed successful reconstruction with a patent airway and viable mucosa. The vascularized sheet of perichondrium was not chosen for its neochondrogenetic effect, but it served as a vascular bed, nourishing the mucous and cartilaginous components in the compound flap. It is suggested that for clinical purposes the reliable fascia forearm flap, which is available in large amounts, can be used as a transferable vascularized bed with a thickness comparable to that of the perichondrial flap.

Cell origin in experimental repair of cricoid cartilage defects treated with recombinant human bone morphogenetic protein‐2

“…Furthermore, MPCs are present in the perichondrium 5 . The perichondrium has been used in experimental models of laryngotracheal reconstruction, and there is clear evidence that it has chondrogenic potential 6–8 …”

A systematic review of simulated laryngotracheal reconstruction animal models

“…Foggia et al quantified this in their study, describing a mean cricoid cross‐sectional area of 15.7 mm 2 in adult rabbits . In addition, the availability of a large quantity of harvestable cartilage for graft material (auricular cartilage), as well as the ability to harvest costal cartilage, is of importance during reconstruction . Two studies also comment on the similarity of the laryngotracheal anatomy between rabbits and humans .…”

“…28 In addition, the availability of a large quantity of harvestable cartilage for graft material (auricular cartilage), as well as the ability to harvest costal cartilage, is of importance during reconstruction. 19,24,[29][30][31][32][33][34] Two studies also comment on the similarity of the laryngotracheal anatomy between rabbits and humans. 20,24 As all the studies utilized rabbits for in vivo experiments, several articles also highlight positive aspects of the rabbit model that only apply to the use of live rabbits.…”

Prefabricated auricular cartilage radial forearm free flap reconstruction for cricoid chondrosarcoma

“…Prefabricated flaps provide a valuable reconstructive option for large cricoid defects and avoid complications related to nonvascularized grafts. Delaere et al revolutionized the approach to cricoid reconstruction in a series of publications . These studies were instrumental in the development of prefabricated composite flaps first in an animal model, then in patients with laryngotracheal defects.…”

“…Delaere et al revolutionized the approach to cricoid reconstruction in a series of publications. [6][7][8] These studies were instrumental in the development of prefabricated composite flaps first in an animal model, then in patients with laryngotracheal defects. Urken et al reported one of the first descriptions of reconstructing a hemicricoid and hemilaryngeal defect, with a sensate radial forearm free flap using costal cartilage in patients with partial laryngopharyngectomies.…”