Cricotracheal reconstruction with free radial forearm flap and titanium mesh

Abstract

This reconstructive technique enabled us to maintain the integrity of the subglottic airway. Our technique was unique in that we used the skin-lined part of the radial forearm flap to line the airway and the fascia to cover the titanium mesh outside, thereby preventing plate exposure.

Extended Open Partial Laryngectomy with Titanium-Based Laryngeal Framework Reconstruction: Surgical Technique and Treatment Outcomes

“…They achieved good functional outcomes with patent airways, showing only a minimum risk of plate exposure and rejection by the host, due to biointegration of titanium with adjacent tissues, which we confirmed in our patients [31].…”

“…Currently, the development of medical technology has allowed for the titanium elements to be manufactured in any shape, size, thickness and with improved medical properties. The literature search yields several reports of titanium-based airway reconstruction and their functional outcomes [7,[29][30][31].…”

Free posterior tibial artery perforator flap for 2‐stage tracheal reconstruction in patients after resection of well‐differentiated thyroid carcinoma invading the trachea

“…Therefore, appropriate reconstruction of the trachea following resection of malignancy is of great importance. Head and neck surgeons have used a wide variety of methods to reconstruct the trachea. However, each method has its own shortcomings.…”

“…Therefore, thin free flaps are probably the better choice for reconstruction of long segments of tracheal defects. Maciejewski, Balasubramanian, and Thomet utilized a radial forearm free flap to reconstruct tracheal defects, combined with biodegradative mesh suspension, titanium mesh, and rib cartilage, respectively. They obtained a satisfactory structure and functional repair results.…”

“…However, tracheal reconstruction after tumor resection poses a great challenge for head and neck surgeons. A large number of approaches to tracheal reconstruction have been used, including tracheal end‐to‐end anastomosis, autologous rib cartilage graft, composite nasal septal graft, pedicled sternocleidomastoid clavicular periosteocutaneous flap, free radial forearm flap combined with biodegradative mesh suspension, free radial forearm flap combined with titanium mesh or rib cartilage, and other free skin grafts . With the development of microsurgical techniques, free skin grafts, such as radial free forearm and free thigh anterolateral flaps, have been widely applied for repairment and reconstruction after head and neck massive surgery.…”