Prefabrication of trachea for the reconstruction of the hemilarynx after hemilaryngectomy for unilateral cancer.

摘要

Although one side of the larynx may be completely healthy, total laryngectomy is advocated in unilateral glottis cancer, since the reconstruction of a hemilarynx for sparing one vocal cord is so complex1. However, every attempt must be made to avoid total laryngectomy since the loss of speech and the need of a permanent tracheostomy drastically alter quality of life. In order to reconstruct the cartilaginous framework after hemilaryngectomy, a tracheal segment is a prefect option, since trachea has a similar cartilaginous structure, internally lined with respiratory mucosa (Fig 1 and 2). However, the trachea does not have a direct vascular network and therefore cannot be isolated for 8 cm to allow for transfer ànd restoration of the hemilarynx. Using a 2-stage prefabrication procedure, we reconstruct the hemilaryngeal defect with a revascularised autologous trachea segment.