One-stage reconstruction of a tracheal defect with a free radial forearm flap and free costal cartilage grafts

Yutaka Fukunaga; Minoru Sakuraba; Shimpei Miyamoto; Shuji Kayano; Koreyuki Kurosawa; Masahide Fujiki; Masanobu Sakisaka; Seiichi Yoshimoto

doi:10.1016/j.bjps.2013.12.053

One-stage reconstruction of a tracheal defect with a free radial forearm flap and free costal cartilage grafts

J Plast Reconstr Aesthet Surg. 2014 Jun;67(6):857-9. doi: 10.1016/j.bjps.2013.12.053. Epub 2014 Jan 8.

Authors

Yutaka Fukunaga¹, Minoru Sakuraba², Shimpei Miyamoto³, Shuji Kayano³, Koreyuki Kurosawa³, Masahide Fujiki⁴, Masanobu Sakisaka³, Seiichi Yoshimoto⁵

Affiliations

¹ Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. Electronic address: yfukunag@east.ncc.go.jp.
² Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
³ Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
⁴ Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
⁵ Department of Head and Neck Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.

PMID: 24476705
DOI: 10.1016/j.bjps.2013.12.053

Abstract

Reconstructing the trachea is challenging because of its multilayer structure and airway function; multiple procedures are often required. We report a case of one-stage reconstruction for a tracheal defect. The surgery was performed with a free radial forearm flap and free costal cartilage grafts. Air leakage occurred postoperatively but healed without additional surgery. The reconstructed trachea has retained its shape, diameter and airway function for 14 months despite the patient's history of radiotherapy. This one-stage procedure with well-vascularised tissue was successfully used to reconstruct a stable, well-functioning trachea.

Keywords: Costal cartilage; Free radial forearm flap; Microsurgery; Tracheal defect; Tracheal reconstruction.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anastomosis, Surgical / methods
Carcinoma / pathology
Carcinoma / surgery*
Cartilage / transplantation*
Follow-Up Studies
Forearm / surgery
Free Tissue Flaps / blood supply
Free Tissue Flaps / transplantation*
Graft Survival
Humans
Male
Microsurgery / methods
Plastic Surgery Procedures / methods*
Postoperative Care / methods
Ribs / surgery
Risk Assessment
Tracheal Neoplasms / pathology
Tracheal Neoplasms / surgery*
Tracheotomy / methods
Treatment Outcome