Hemilaryngeal reconstruction using an axial island cheek flap supported by Marlex and stainless steel wire mesh

The defect that remains after an extended hemilaryngectomy continues to be a challenge to the reconstructing surgeon. The reconstruction ideally must provide airway protection against aspiration, allow for phonation, and provide a durable mucosal surface. It also must be accomplished in one stage. Nine Labrador dogs underwent successful reconstruction of the hemilarynx using an axial island cheek flap based on the facial artery and vein. Adequate laryngeal function was demonstrated by maintenance of body weight, normal barium swallows, return of strong bark, and no evidence of aspiration pneumonia. Pathologic review confirmed a viable mucosal surface and incorporation of the Marlex and stainless steel wire mesh in a fibrous reaction. We have concluded that this method of reconstruction provides a result superior to currently used techniques.