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- Title
The prefabricated supraclavicular artery flap in high-risk tracheal stenosis patients.
- Authors
Zender, Chad A.; Patel, Akshay V.; Strohl, Madeleine; Melki, Sami; Maronian, Nicole
- Abstract
<bold>Objectives/hypothesis: </bold>Primary tracheal resection in appropriately selected patients with tracheal stenosis achieves >90% success rate. Risk factors for complications have been identified, making some patients high risk for this procedure. Herein is a review and discussion of a novel treatment method for tracheal stenosis utilizing a prefabricated composite auricular cartilage graft embedded in a supraclavicular artery island flap (pSCAIF) for tracheal reconstruction in high-risk patients.<bold>Study Design: </bold>Retrospective case series.<bold>Methods: </bold>After institutional review board approval, cases were analyzed after data collection. Between 2014 and 2016, eight patients underwent airway reconstruction using an auricular cartilage graft prefabricated within a supraclavicular artery island flap reconstruction; all of these were included in the study. Each case was reviewed, and relevant details of patient and disease characteristics, operative course, postoperative course, decannulation, and status at last follow-up were isolated and reported.<bold>Results: </bold>Seven of eight patients were female. The most common cause of stenosis was iatrogenically induced multilevel stenosis (7/8 patients). All patients had undergone prior airway procedures, were high risk based on comorbid conditions, and underwent grafting and reconstruction with a composite supraclavicular island flap. All patients continue to follow up in a multidisciplinary clinic, and at last follow-up, eight of eight patients were successfully decannulated.<bold>Conclusions: </bold>The pSCAIF is a novel method for tracheal reconstruction. The analysis of the prefabricated locoregional approach cohort supports its utility for tracheal reconstruction in patients with complicated multilevel stenosis and adverse comorbidities and characteristics.<bold>Level Of Evidence: </bold>4 Laryngoscope, 130:641-648, 2020.
- Subjects
TRACHEAL stenosis; BRACHIAL plexus block; INSTITUTIONAL review boards; ARTERIES; ARTERY transplantation; CARTILAGE transplantation; TRACHEAL surgery; TRACHEAL diseases; SURGICAL flaps; PLASTIC surgery; RETROSPECTIVE studies; EAR; TREATMENT effectiveness; CLAVICLE
- Publication
Laryngoscope, 2020, Vol 130, Issue 3, p641
- ISSN
0023-852X
- Publication type
journal article
- DOI
10.1002/lary.28068