Relaxation Technique for Tracheal Reconstruction

Laryngotracheal obstruction complicating tracheostomy or endotracheal intubation with assisted respiration. A critical review.

“…After resection of long lengths of the trachea tension on the suture line may be reduced by performing a Z-plasty (Narodick, Worman, and Pemberton, 1965;Worman, Starr, and Narodick, 1966), and this technique has been mentioned in connexion with post-tracheostomy stenosis by Deverall (1967) and Pearson et al (1968). Two hemispherical incisions are made through opposite halves of the circumference of the remaining tracheal wall, one above the other, and each bet\ een two cartilages.…”

“…The grafts epithelialize early, soon become rigid, and are not liable to infection, and in these respects are superior to synthetic materials such as Teflon. The periosteal pedicle graft is prepared from the bed of a resected rib and is applied so that the periosteal surface is towards the tracheal lumen (Narodick et al, 1965). This procedure should rarely be required for post-tracheostomy strictures.…”

Tracheal stricture following tracheostomy

“…Flavell in 1959 described this technique, and a further successful result was published by Binet and Aboulker (1961). Tracheal tension at the suture line may be reduced by using the Z plasty technique described by Narodick, Worman, and Pemberton (1965) and Worman, Starr, and Narodick (1966). Recurrent laryngeal nerve damage has occurred in one patient (case 6).…”

Tracheal Tissue Engineering

“…Luckily, during the 1950s and 60s there were significant strides in tissue and organ transplantation, including the first [11,35,38,61], cartilage [13,62], dermal grafts [14,56], pericardium [63], free periosteum wrap [64,65,66], bone strips [21], stented cartilage and perichondrium [67], costal cartilage, periosteum and rib [68], composite patches of buccal mucosa and auricular cartilage, [69] dura mater with wire [70], bladder mucosa [51,71,72,73], jejunal patches [74], and perichondrium from ear and rib [75]. For all of these attempts, it was found that autogenous patches generally results in fibrotic contraction with patchy epithelization.…”