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Laryngotracheal reconstruction with autogenous rib cartilage graft for complex laryngotracheal stenosis and/or anterior neck defect

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

To study the effectiveness of laryngotracheal reconstruction with rib cartilage graft for complex laryngotracheal stenosis and/or anterior neck defect, 62 patients with complex laryngotracheal stenosis and/or anterior neck defect underwent laryngotracheal reconstruction with autogenous rib cartilage graft. The surgical procedures were laryngotracheotomy with rib cartilage graft interposition and silicon-tube stent placed in the region of laryngotracheal stenosis and/or anterior neck defect for the period of between 10 days and 12 months. Three patients with complex subglottic stenosis and anterior neck defects underwent a single-stage reconstruction with a combined rib cartilage graft interposition and fasciocutaneous flap reparation. One patient with a complex subglottic and superior thoracic tracheal stenosis underwent a staged operation. Of the 62 patients, 46 patients (74.1 %) were successfully decannulated. One patient had combined subglottic stenosis, which was healed, and superior thoracic tracheal stenosis, which is undergoing treatment. 15 patients (24.2 %) had failure in decannulation due to either wound infection followed by rib cartilage necrosis, or granulation tissue formation and restenosis. Of these 15 patients, ten required revision operations and delayed healing. The duration of follow-up ranged from 1 to 10 years. Of 46 patients, who were successfully decannulated, 36 had a satisfactory airway and a functional voice; two had restenosis due to partial laryngectomy for laryngocarcinoma recurrence 1 year after decannulation; eight were lost to follow-up after successfully decannulated. We conclude that this method can provide effective treatment for complex laryngotracheal stenosis and/or anterior neck defects. It is relatively simple with a high decannulation rate in selected patients.

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Acknowledgments

We would like to thank Dr. Weiwen Long and Dr. Luping Huang for editing the article.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Otolaryngology, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shanxi, 710038, People’s Republic of China

    Liu Zhi, Wu Wenli, Gao Pengfei, Cui Pengcheng, Chen Wenxian, Luo Jiasheng & Sun Yongzhu

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  1. Liu Zhi
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  2. Wu Wenli
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  3. Gao Pengfei
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  4. Cui Pengcheng
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  5. Chen Wenxian
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  6. Luo Jiasheng
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  7. Sun Yongzhu
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Corresponding author

Correspondence to Chen Wenxian.

Additional information

L. Zhi and W. Wenli contributed equally to this work.

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Zhi, L., Wenli, W., Pengfei, G. et al. Laryngotracheal reconstruction with autogenous rib cartilage graft for complex laryngotracheal stenosis and/or anterior neck defect. Eur Arch Otorhinolaryngol 271, 317–322 (2014). https://doi.org/10.1007/s00405-012-2256-4

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  • DOI: https://doi.org/10.1007/s00405-012-2256-4

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