Hemilaryngeal transplantation in the canine model: technique and implications.
OBJECTIVE
There is no ideal method for reconstruction of hemilaryngeal defects because there is no autologous flap or graft that can reproduce the unique structural properties of the larynx. In this article, the technique, potential research, and clinical applications of hemilaryngeal transplantation are addressed.


METHODS
In a canine model, transplantation of a hemilarynx was performed. The thyroarytenoid muscle was reinnervated, and an arytenoid adduction was performed to ensure a competent larynx during the early postoperative period.


RESULTS
The canine tolerated the procedure well and the transplanted larynx remained healthy and well vascularized during the postoperative period. Electromyography of the transplanted thyroarytenoid muscle verified reinnervation 2 months after the procedure. During induced phonation, vibration was symmetrical with a normal-appearing laryngeal geometry.


CONCLUSIONS
Preliminary experience indicates that this technique has unique advantages compared with other available techniques for laryngeal reconstruction. Only with additional progress in transplantation medicine could this procedure be considered an option for reconstruction of human partial laryngeal defects.
Andrews
R J
RJ
Division of Head and Neck Surgery, UCLA Medical Center, Los Angeles, CA 90095, USA.
Berke
G S
GS
Blackwell
K E
KE
Jakobsen
M
M
Wang
M B
MB
Sercarz
J A
JA
D000818:Animals; D004285:Dogs; D004576:Electromyography; D007165:Immunosuppression Therapy; D007825:Laryngectomy / Q000379:methods*; D007830:Larynx / Q000473:pathology / Q000503:physiopathology / Q000637:transplantation*; D008297:Male; D011182:Postoperative Care; D012680:Sensitivity and Specificity; D013524:Surgical Flaps / Q000294:innervation*; D016896:Treatment Outcome