Human tracheal reconstruction with a composite radial forearm free flap and prosthesis

Reconstruction of large tracheal defects has been largely unsuccessful. We report a novel single-stage tracheal reconstruction for a 6.5-cm long defect involving the anterior two thirds of the tracheal circumference in a patient with deeply infiltrative thyroid cancer into the tracheal lumen. The reconstruction was completed using a conduit composed of a radial forearm free flap for lining with a combined PolyMax mesh (Synthes, Paoli, PA) and Hemashield vascular graft (Boston Scientific, Natick, MA) for rigid support. At a 6-month follow-up the patient has normal swallowing and preoperative voice quality, and she maintains a patent, non-stented airway.