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

Abstract

Background: Laryngotracheal stenosis (LTS) can cause persistent or recurrent airway obstruction. Although there is extensive literature on surgical techniques to treat LTS at onset, there are few techniques described for complex adult LTS after failed prior airway surgery. We describe a procedure used successfully in 3 patients who required structural augmentation for complex LTS.

Methods: Patients were treated with staged reconstruction using a prefabricated composite graft consisting of auricular cartilage and a radial forearm free flap.

Results: All patients underwent successful reconstruction with good wound healing and are tolerating oral diets. Two patients have been successfully decannulated.

Conclusion: A delayed prefabricated graft using auricular cartilage in a radial forearm free flap is a viable surgical intervention in patients with complex adult LTS who are not candidates for conventional approaches.

Keywords: cricoid reconstruction; laryngotracheal reconstruction; laryngotracheal stenosis; prefabricated flap.