title: Complex adult laryngotracheal reconstruction with a prefabricated flap: a case series.
abstract: BACKGROUND
  Laryngotracheal stenosis (LTS) can cause persistent or recurrent airway obstruction. Although there is extensive literature on surgical techniques to treat LTS at onset, there are few techniques described for complex adult LTS after failed prior airway surgery. We describe a procedure used successfully in 3 patients who required structural augmentation for complex LTS.
  
  
  METHODS
  Patients were treated with staged reconstruction using a prefabricated composite graft consisting of auricular cartilage and a radial forearm free flap.
  
  
  RESULTS
  All patients underwent successful reconstruction with good wound healing and are tolerating oral diets. Two patients have been successfully decannulated.
  
  
  CONCLUSIONS
  A delayed prefabricated graft using auricular cartilage in a radial forearm free flap is a viable surgical intervention in patients with complex adult LTS who are not candidates for conventional approaches.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.
authors.forename: Kara Y
authors.initials: KY
authors.lastname: Detwiller
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Schindler
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Schneider
authors.forename: Robert
authors.initials: R
authors.lastname: Lindau
mesh_terms: D000328:Adult; D000368:Aged; D004425:Ear Cartilage / Q000637:transplantation*; D005542:Forearm; D058752:Free Tissue Flaps; D014890:Granulomatosis with Polyangiitis / Q000150:complications; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects; D007829:Laryngostenosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014135:Tracheal Stenosis / Q000209:etiology / Q000601:surgery*; D014138:Tracheoesophageal Fistula / Q000150:complications
keywords: cricoid reconstruction; laryngotracheal reconstruction; laryngotracheal stenosis; prefabricated flap