[Four-layer laryngotracheoplasty to repair an anterior tracheal wall defect induced by a Montgomery T-tube].
A 37-year old patient was referred in 2000 for reconstruction of the anterior tracheal wall eroded by a Montgomery T-tube. A four-layer laryngotracheoplasty was proposed to the patient. The endotracheal plane was reconstructed by a bilateral random pattern quadrangular skin hinge flap raised from both sides of the defect. The chondral plane was realized with conchal cartilage. This cartilage graft was covered with an inferiorly based sternocleidomastoid flap. The fourth layer was a mesh split-thickness skin graft. Satisfactory and lasting results were observed during a three-year follow-up. Few articles deal specifically with tracheal reconstruction after anterior wall erosion induced by a Montgomery-T tube. We found no mention of the described four-layer flap in the literature.
Dagrégorio
G
G
Centre hospitalo-universitaire de Poitiers, département de chirurgie plastique et de la main, France. verone4@wanadoo.fr
Duport
G
G
Fontanel
J-P
JP
D000328:Adult; D002356:Cartilage / Q000637:transplantation; D006801:Humans; D007049:Iatrogenic Disease; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007830:Larynx / Q000293:injuries* / Q000601:surgery*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D014132:Trachea / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome