[Experimental study on tracheal reconstruction using porous titanium rings and free skin flap]

To investigate the feasibility and efficacy of the cervical tracheal reconstruction using porous titanium rings and free skin flap.

Twelve adult mongrel dogs were divided randomly into group I and group lI. A segment of cervical trachea (25 mm, 4 rings, about 2/3 circumference) was resected and a rectangular free skin flap was harvested from abdomen. The flap was sutured to the defect part and supported with two porous titanium rings (group I) or without (group II ). X ray and fiberscopic examinations were performed at the end of the first and the sixth months postoperatively. After six months the dogs were sacrificed and the grafts were examined macroscopically and microscopically.

In group I, one dog was sacrificed for wound infection and skin flap necrosis with deflexion of titanium rings in the fifth day postoperatively. The other 5 of 6 survived until the end of six months. X-ray examination showed titanium rings were fastened well without displacement or deformity. Through fiberscopy, the trachea luminal patency was maintained well without stricture, shrinkage or necrosis. Histologic examination showed most of the inner surface of the flap was covered with ciliated columnar epithelium. In group II, 3 of 6 dogs died of suffocation within 24 hours postoperatively. The remaining 3 dogs survived from 7 to 16 days with dyspnea and fiberscopic examination showed narrowed trachea lumens.

Porous titanium rings could recreate the framework for cervical tracheal reconstruction using free skin flap and would be one of the options for tracheal reconstruction.