Nasotracheal airway-oropharyngeal alimentary canal: a microvascular technique for reconstruction of the upper airway after total laryngectomy.
Every patient who has to be laryngectomized because of a carcinoma is concerned with the loss of his or her voice and the presence of a permanent tracheostoma in his or her neck. While various methods for producing a substitute voice are available (esophageal voice, voice devices, voice-shunt operations with or without voice prosthesis), it is usually impossible after laryngectomy to reconstruct a complete upper airway so that the tracheostoma can be closed. One potential method for reconstruction of the airway is its division into a nasotracheal airway and an oropharyngeal alimentary canal. Ten Alsatian dogs were laryngectomized, and a microvascularly anastomosed jejunal autograft was inserted as a junction between the tracheal stump and the circularly exposed nasopharynx, while the pharynx was reconstructed separately. One week postoperatively, oral feeding could be started again; at the same time breathing was possible via the reconstructed nasotracheal airway, which was kept open by insertion of a silicone tube. By means of this microvascular technique, a complete nasal airway could be reconstructed surgically after laryngectomy.
Hagen
R
R
Department of Otorhinolaryngology, University of Würzburg, Germany.
Schwab
B
B
Marten
S
S
D000714:Anastomosis, Surgical; D000818:Animals; D004285:Dogs; D004750:Enteral Nutrition; D005260:Female; D007441:Intubation, Gastrointestinal; D007442:Intubation, Intratracheal; D007583:Jejunum / Q000637:transplantation*; D007825:Laryngectomy; D008297:Male; D009305:Nasopharynx / Q000601:surgery*; D009960:Oropharynx / Q000601:surgery*; D012119:Respiration; D014132:Trachea / Q000601:surgery*; D014139:Tracheostomy; D014182:Transplantation, Autologous