title: Tracheal autotransplantation: guidelines for optimal functional outcome.
abstract: OBJECTIVE
  Tracheal autotransplants can repair extensive hemilaryngectomy defects. This technique was introduced into the clinic some 10 years ago as a means of avoiding the mutilation of a total laryngectomy in selected patients with laryngeal cancer. Our goal was to give the morphometric guidelines that guarantee an optimal functional outcome.
  
  
  METHODS
  Retrospective case study.
  
  
  METHODS
  We morphometrically evaluated the structure and function of the larynx after autotransplantation. The close anatomic relationship between the larynx and the trachea made it possible to perform a morphometric analysis of the defect and the repair tissue before and after transplantation. Computed tomography images were used to measure the laryngeal and tracheal airway lumen and the length and width of the tracheal autotransplant. A 4-cm long cartilaginous tracheal transplant was available for reconstruction.
  
  
  RESULTS
  Laryngeal repair was achieved with optimal restoration of the airway lumen at all laryngeal levels. We used the maximal amount of trachea that might reasonably be available for autotransplantation. This optimal morphologic repair led to the restoration of speech, swallowing, and respiratory functions.
  
  
  CONCLUSIONS
  This study highlights a standardized approach for repairing a hemilaryngeal defect and selecting the appropriate amount of repair tissue. A unique characteristic of vascularized cartilaginous trachea is that it restores the airway lumen after extensive hemilaryngectomy. Tracheal autotransplantation should be included in the armamentarium of reconstructive laryngeal procedures.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University Hospital Leuven, Leuven, Belgium. Pierre.Delaere@uz.kuleuven.be
authors.forename: Pierre R
authors.initials: PR
authors.lastname: Delaere
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Vranckx
authors.forename: Christophe
authors.initials: C
authors.lastname: Dooms
authors.forename: Jeroen
authors.initials: J
authors.lastname: Meulemans
authors.forename: Robert
authors.initials: R
authors.lastname: Hermans
mesh_terms: D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D014132:Trachea / Q000637:transplantation*; D014182:Transplantation, Autologous / Q000379:methods