Prefabricated auricular cartilage radial forearm free flap reconstruction for cricoid chondrosarcoma

Jackson, Ryan; Martin, Eliot J.; Moore, Eric J.

doi:10.1002/lary.25510

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…Another shortcoming of these types of procedures is the impossibility to completely reproduce the laminated airway structure, composed by a cartilaginous skeleton in support to a respiratory epithelium. Therefore, the most successful surgical interventions imply the use of composite flaps with the association of various grafts 16 , 17 . In this regard, Delaere and coworkers described tracheal auto- and allotransplantation techniques, which were also applied with good results in cases of cricoid CS 18 , 19 .…”

Section: Discussionmentioning

confidence: 99%

Hemicricoidectomy with modified rotational thyro-crico-tracheal anastomosis: a newborn in the family of crico-tracheal resection and anastomosis techniques

Piazza,

Lancini,

Zigliani

et al. 2023

Acta Otorhinolaryngol Ital

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SUMMARY Objective The aim of the present study is to describe our novel surgical technique of hemicricoidectomy and reconstruction with modified rotational thyro-crico-tracheal anastomosis for the treatment of non-squamous cell subglottic tumours. The procedure has been defined as Type E crico-tracheal resection and anastomosis (CTRA) following the University of Brescia (C)TRA classification introduced elsewhere. Methods A detailed anatomical step-by-step dissection was reproduced and illustrated on a cadaveric laryngo-tracheal specimen. Moreover, oncological and functional outcomes of the first 5 patients who underwent Type E CTRA at our Institution between October 2016 and September 2022 are described. Results Three patients underwent Type E CTRA for cricoid chondrosarcoma (CS) and 2 patients for subglottic adenoid cystic carcinoma (ACC). No post-operative complication was reported. All patients maintained intact oral intake and an intelligible voice at discharge. All but one patient with obstructive sleep apnoea hypopnea syndrome and lung comorbidity were successfully decannulated before discharge. At the last follow-up (April 2023), one patient experienced local recurrence of CS that was still amenable to conservative treatment by transoral debulking, while the remaining patients were free of disease. Conclusions With the proper indications, Type E CTRA is a feasible and effective conservative surgical technique for selected non-squamous cell subglottic tumours.

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Section: Discussionmentioning

confidence: 99%

Hemicricoidectomy with modified rotational thyro-crico-tracheal anastomosis: a newborn in the family of crico-tracheal resection and anastomosis techniques

Piazza,

Lancini,

Zigliani

et al. 2023

Acta Otorhinolaryngol Ital

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“…8). The radial forearm flap can be used in flap prefabrication (30,31), such as cartilage transfer for reconstruction in the face.…”

Section: Discussionmentioning

confidence: 99%

Radial Flap in Reconstructions of the Hand - Case Series Study

Vulović

Kozarski

Curcic

et al. 2022

Serbian Journal of Experimental and Clinical Research

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Radial forearm flap is an axial flap that has become an important technique in reconstructive surgery as a free flap or as a pedicled flap. Defects of the skin and other tissues on the hand are very common and most often they are work-related injuries. In deep defects, flap must be used, as well as in reconstruction of the amputated thumb. There are many flaps that provide adequate soft tissue coverage for the hand. Therefore, the aim of this paper is to present the results of the use of radial forearm flap in various reconstructions on the hand. The retrospective study included 35 patients who underwent reconstruction with radial forearm flaps due to defects of the skin and other tissues on the hand, in the period 1997-2019. Results and complications of the surgery were analyzed. The functional and aesthetic outcome was assessed using Michigan Hand Outcome Qusteionnarire. All patients were followed for a minimum of 1 year. Fasciocutaneous flap was the most commonly used (65.71%), followed by adiposofascial (20%) and osteocutaneous (14.29%). The size of the fasciocutaneous flap ranged from 2.2x3.1cm to 9x13.5cm. The majority of donor sites were closed with split-thickness skin grafts (56.52%), and less frequently with direct suture, local skin flap, and full-thickness skin graft. There were no complete flap losses in the study. Marginal necrosis was noted in 8.57%, and graft failure at the donor site in 14.29%. Secondary surgical procedures were performed in 13 patients. The functional-aesthetic result of the operation, based on the MHQ score, ranged from 31 (1/35) to 130 points (3/35). The ultimate aim of hand reconstruction is to restore sufficient function and form, also, closing the wound within three days following the injury is desirable. Meticulous intraoperative dissection of radial flap and early physical therapy after surgery are mandatory. The radial flap is a suitable method, especially for large and more distal skin defects on the hand, and a very good method for thumb reconstruction.

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“…In 2001, Delaere et al reported using prefabricated composite grafts for augmentation of the anterior cricoid cartilage and tracheal defects in rabbits . Similar techniques have been used successfully to reconstruct hemilaryngeal defects and postablation defects following resection of laryngeal malignancies . In 2009, Fujiwara et al described tracheal reconstruction using a prefabricated double‐folded radial forearm free flap with costal cartilage for two patients requiring a tracheal resection for papillary thyroid carcinoma .…”

Section: Discussionmentioning

confidence: 99%

“…11 Similar techniques have been used successfully to reconstruct hemilaryngeal defects and postablation defects following resection of laryngeal malignancies. 12,13 In 2009, Fujiwara et al described tracheal reconstruction using a prefabricated double-folded radial forearm free flap with costal cartilage for two patients requiring a tracheal resection for papillary thyroid carcinoma. 14 Cheng et al described the successful use of pRFFF in laryngotracheal reconstruction following ablation of invasive papillary thyroid carcinoma, which included the lower half of the laryngeal framework and ipsilateral first and second tracheal ring.…”

Section: Prefabricated Graftingmentioning

confidence: 99%

The prefabricated supraclavicular artery flap in high‐risk tracheal stenosis patients

et al. 2019

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Objectives/Hypothesis Primary tracheal resection in appropriately selected patients with tracheal stenosis achieves >90% success rate. Risk factors for complications have been identified, making some patients high risk for this procedure. Herein is a review and discussion of a novel treatment method for tracheal stenosis utilizing a prefabricated composite auricular cartilage graft embedded in a supraclavicular artery island flap (pSCAIF) for tracheal reconstruction in high‐risk patients. Study Design Retrospective case series. Methods After institutional review board approval, cases were analyzed after data collection. Between 2014 and 2016, eight patients underwent airway reconstruction using an auricular cartilage graft prefabricated within a supraclavicular artery island flap reconstruction; all of these were included in the study. Each case was reviewed, and relevant details of patient and disease characteristics, operative course, postoperative course, decannulation, and status at last follow‐up were isolated and reported. Results Seven of eight patients were female. The most common cause of stenosis was iatrogenically induced multilevel stenosis (7/8 patients). All patients had undergone prior airway procedures, were high risk based on comorbid conditions, and underwent grafting and reconstruction with a composite supraclavicular island flap. All patients continue to follow up in a multidisciplinary clinic, and at last follow‐up, eight of eight patients were successfully decannulated. Conclusions The pSCAIF is a novel method for tracheal reconstruction. The analysis of the prefabricated locoregional approach cohort supports its utility for tracheal reconstruction in patients with complicated multilevel stenosis and adverse comorbidities and characteristics. Level of Evidence 4 Laryngoscope, 130:641–648, 2020

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Prefabricated auricular cartilage radial forearm free flap reconstruction for cricoid chondrosarcoma

Cited by 7 publications

References 10 publications

Hemicricoidectomy with modified rotational thyro-crico-tracheal anastomosis: a newborn in the family of crico-tracheal resection and anastomosis techniques

Hemicricoidectomy with modified rotational thyro-crico-tracheal anastomosis: a newborn in the family of crico-tracheal resection and anastomosis techniques

Radial Flap in Reconstructions of the Hand - Case Series Study

The prefabricated supraclavicular artery flap in high‐risk tracheal stenosis patients

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