Laryngeal reconstruction following vertical partial laryngectomy

Area of Science:

• Veterinary Surgery
• Laryngology
• Regenerative Medicine

Context:

• Vertical partial laryngectomy (VPL) with arytenoidectomy necessitates effective laryngeal reconstruction.
• Thyroid cartilage flaps (TCFs) offer a potential solution for restoring laryngeal structure and function.
• Evaluating TCF variations and muscle coverage is crucial for optimizing surgical outcomes.

Purpose:

• To assess the efficacy of superiorly based thyroid cartilage flaps (TCFs) in laryngeal reconstruction following VPL with arytenoidectomy in a canine model.
• To evaluate the functional and structural outcomes of TCF reconstruction, including arytenoid replacement, pseudocord formation, and airway patency.
• To analyze the histological characteristics and survival of the TCF and surrounding tissues over a 6-month period.

Summary:

• Superiorly based TCFs were used for laryngeal reconstruction in 30 dogs undergoing VPL with arytenoidectomy.
• Endoscopic and histological assessments at 6 months showed high rates of successful arytenoid replacement (up to 100%), functional pseudocord development (up to 94%), and normal airway patency (100%).
• The TCF demonstrated good survival and was largely replaced by bone, covered by appropriate epithelium, with minimal complications like granulation tissue or cartilage necrosis.

Impact:

• This research provides evidence for the successful use of TCFs in complex laryngeal reconstructions, offering a viable technique for restoring laryngeal function.
• The findings suggest that TCFs can achieve excellent functional and structural results, minimizing the risk of airway stenosis.
• The study highlights the potential of TCFs in veterinary laryngeal surgery and may inform future human reconstructive techniques.