Abstract
Objective: Techniques available for reconstruction of the crico-tracheal region in adults are currently suboptimal. We sought to 1) Understand the anatomic basis for the thyroid perichondrial flap, 2) Describe the technique of harvesting and intraluminal placement, and 3) Learn the limitations of defects for which it can be used.
Method: In fresh cadaveric specimens, the perichondrium of the outer layer of the thyroid cartilage was elevated by tracing the superior, medial and lateral borders of each thyroid cartilage ala. The inferiorly based flap was then placed into the airway through the cricothyroid membrane. The extent of coverage was measured.
Results: Current results are limited to female cadaveric measurements only. The extent of thyroid perichondrial flaps were 1.7 and 1.8 cm on the right and left respectively. The flaps were able to completely cover the cricoid cartilage and extended to but did not cover the first tracheal ring. Once placed intraluminally the flaps extended 2.5 and 2.6 cm below the true vocal cords on the right and left respectively. Using both flaps enabled coverage of the entire anterior 180 degrees of the airway lumen.
Conclusion: The thyroid perichondrial flap is technically feasible and can provide coverage of anterior airway defects up to approximately 2.5 cm below the true vocal cords. This flap could enable transfer of vascularized tissue to aid in crico-tracheal reconstruction. Further work in male cadavers as well as animal studies are in progress.
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