A UNIVERSALLY ideal tracheal replacement has been a challenging but as yet unsolved surgical problem. Defects involving a portion of the tracheal circumference may satisfactorily be repaired with grafts of autogenous fascia or cartilage1 and longitudinal defects may be repaired with skin grafts supported with wire sutures.2,3
In the past, circumferential cervical tracheal defects of not more than 2 cm were repaired by mobilization and end-to-end anastomosis4,5; however, recent work6 has demonstrated that as much as 4 cm of cervical trachea may be excised and the end-to-end anastomosis accomplished. Still longer segments of trachea may be excised, but in order to accomplish an end-to-end anastomosis a thoracotomy must be performed to free the tracheobronchial tree.
Circumferential defects greater than 4 cm usually require a staged reconstructive procedure utilizing skin flaps7,8 if a thoracotomy is to be avoided. As previously noted,9 very limited success has
Fredrickson JM, Strahan RW, Goode RL. Reinforced T-Tube Tracheal Stent. Arch Otolaryngol. 1969;90(3):356–359. doi:10.1001/archotol.1969.00770030358018
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: