Laryngotracheal transplantation

Abstract

We have demonstrated that our methods may result in a successful laryngotracheal transplant. We describe the preparation, surgical technique, rehabilitation, and interventions employed in achieving optimal outcomes. This report contributes valuable information on this rarely performed composite transplant.

Regeneration – eine neue therapeutische Dimension in der Hals-Nasen-Ohrenheilkunde

“…Larynx transplantation is currently mainly a theoretical option that can only be applied in exceptional cases and that is not suitable for reconstruction after tumor surgery. However, it has been described twice in the literature 93 94 . To create an artificial larynx, the production of various tissues, including cartilage, laryngeal muscles, and laryngeal mucosa, must be coordinated.…”

“…Hamilton und Birchall gehen in einer aktuellen Übersicht davon aus, dass die Therapie des Larynxkarzinoms in den kommenden 10 Jahren durch die Entwicklungen im Bereich der Larynxregeneration entscheidend beeinflusst werden wird 92 . Die Larynxtransplantation ist eine derzeit v. a. theoretische Option, die aufgrund der notwendigen Immunsuppression nur in Ausnahmefällen und nicht für die Rekonstruktion nach Tumorchirurgie in Betracht kommt, aber auch bereits 2-mal in der Literatur beschrieben wurde 93 94 . Für die Herstellung eines artifiziellen Larynx ist die Herstellung so unterschiedlicher Gewebe wie des knorpeligen Gerüsts, der laryngealen Muskulatur und der laryngealen Schleimhaut in koordinierter Weise erforderlich.…”

Prosthetic reconstruction of the trachea: A historical perspective

“…Recently, research has focused on tracheal stem cell regeneration. Despite initial positive results, the outcomes have been generally poor and as such should be used with caution[42]. Pedicled flaps may serve to implant and maintain the stem cell generated trachea prior to reconstruction[41].…”

Laryngeal Transplantation

“…The recipient underwent a narrow field laryngectomy in preparation for transplantation. The distal trachea was not removed so that a proper tracheostomy might be applied in the event that the transplantation failed (16). The patient's right superior thyroid artery, bilateral transverse cervical arteries, and bilateral internal jugular veins were prepared for microanastomosis.…”