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Tracheal transplantation: superior and inferior thyroid artery perfusion territory
J Salmeron1, P J Gannon, K E Blackwell
1Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, USA.
Objective:
To determine the perfusion territories of the superior and inferior thyroid arteries in humans. Tracheal transplantation is a potential option for management of long-segment tracheal stenosis. However, the maximum length of vascularized trachea that can be reliably transplanted has not been established.
Study Design:
The tracheal vascular territory of individual superior and inferior thyroid arteries was determined separately in 10 humans postmortem.
Methods:
India ink was infused unilaterally under controlled pressure into the superior (n = 5) and inferior (n = 5) thyroid arteries of cadaveric tracheas. Tracheas were sectioned longitudinally and the caudalmost extent of mucosal dye staining was determined via microscopic assessment.
Results:
The tracheal perfusion territory of the superior thyroid artery was two to five rings (1.7 +/- 0.5 cm) and the inferior thyroid artery, nine to 13 rings (6.5 +/- 1.1 cm). In both cases, the tracheal mucosa on the contralateral side was stained to the same caudal level.
Conclusions:
The inferior thyroid artery was shown to perfuse the trachea maximally to the 13th ring (8.1 cm). As such, the unilateral inferior thyroid artery would serve as a suitable vascular component for long-segment tracheal transplantation in humans.