Experimental and clinical reconstructive surgery of the larynx and trachea

Laboratory study was undertaken to define the healing patterns of intramural bone and cartilage grafts in the canine trachea. These studies indicate that with solid intramural grafting, both displacement and resorption prevent predictably successful graft incorporation. With graft failure, intraluminal stenting maintained separation of the cricotracheal incisional margins so that strap musculature adhered and subsequently fibrosed to provide a rigid and expanded anterior wall. The concept of direct strap-muscle intramural grafting for tracheal expansion was applied in a clinical setting using eight patients having extensive laryngotracheal stenosis. Successful reconstruction occurred in seven of the eight patients.