Repair of Laryngeal Stenosis with Nasal Septal Grafts

Abstract

Autogenous nasal septal grafts were utilized in 18 dogs. The availability, method of transfer, placement, take, stability and long-term survival of these grafts are presented. Transfer of septal cartilage or composite grafts of nasal mucosa and cartilage to surgically created defects of cricoid and thyroid cartilage was performed on eight animals. Ten animals had composite grafts three months after stenosing procedures. Results were excellent in all grafts to the cricoid and subglottic areas. Grafts to the thyroid and glottic regions were characterized by severe resorption of Cartilage and fibrosis. Composite grafts to the glottic area were successful in improving the airway. Results are documented by microlaryngeal photographs and histologic sections. A literature review accompanies the presentation with emphasis on clinical utilization of composite nasal septal grafts. Twelve previously reported cases of repair by this method for laryngeal and upper tracheal stenosis are discussed. A patient with severe traumatic laryngeal stenosis successfully rehabilitated is added to this list and details the clinical value of these grafts.