title: Tracheal reconstruction with a modified infrahyoid myocutaneous flap.
abstract: Reconstruction of a tracheal defect is a challenge because it often requires invasive surgery associated with relatively high morbidity. We recently invented a less-invasive method using a modified infrahyoid myocutaneous (IHMC) flap for the reconstruction of a tracheal defect in an 83-year-old male. A tracheal defect, the right half of the cricoid cartilage plus the right three quarters of the I-IV tracheal cartilage (about 3 × 4 cm), was reconstructed with a modified IHMC flap composed of the sternohyoid and platysma muscles and a skin pedicle. Considering the age of patient, we avoided rigid reconstruction and used a soft silicone tracheal opening retainer (Koken Co., Ltd., Tokyo, Japan) as an anterior wall dilator after surgery and waited for the scarring of the flap until it become rigid enough. The postoperative course was uneventful and the trachea was reconstructed safely. Tracheal reconstruction with an IHMC flap is a useful and less-invasive alternative compared to end-to-end anastomosis or reconstruction with a forearm flap, which is currently used as a mainstay.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Kyushu Koseinenkin Hospital, Kitakyushu, Japan. mmuneyuki@jcom.home.ne.jp
authors.forename: Muneyuki
authors.initials: M
authors.lastname: Masuda
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kamizono
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Ejima
authors.forename: Akiko
authors.initials: A
authors.lastname: Fujimura
authors.forename: Hideoki
authors.initials: H
authors.lastname: Uryu
authors.forename: Hideki
authors.initials: H
authors.lastname: Kadota
mesh_terms: D000369:Aged, 80 and over; D004724:Endoscopy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000601:surgery*; D014133:Tracheal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*