title: Advances in tracheal reconstruction.
abstract: A recent revival of global interest for reconstruction of long-segment tracheal defects, which represents one of the most interesting and complex problems in head and neck and thoracic reconstructive surgery, has been witnessed. The trachea functions as a conduit for air, and its subunits including the epithelial layer, hyaline cartilage, and segmental blood supply make it particularly challenging to reconstruct. A myriad of attempts at replacing the trachea have been described. These along with the anatomy, indications, and approaches including microsurgical tracheal reconstruction will be reviewed. Novel techniques such as tissue-engineering approaches will also be discussed. Multiple attempts at replacing the trachea with synthetic scaffolds have been met with failure. The main lesson learned from such failures is that the trachea must not be treated as a "simple tube." Understanding the anatomy, developmental biology, physiology, and diseases affecting the trachea are required for solving this problem.
authors.affiliation: Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, University Health Network and McEwen Centre for Regenerative Medicine, Toronto, Ontario, Canada; and Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Siba
authors.initials: S
authors.lastname: Haykal
authors.affiliation: Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, University Health Network and McEwen Centre for Regenerative Medicine, Toronto, Ontario, Canada; and Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Salna
authors.affiliation: Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, University Health Network and McEwen Centre for Regenerative Medicine, Toronto, Ontario, Canada; and Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Waddell
authors.affiliation: Latner Thoracic Surgery Research Laboratories, Division of Thoracic Surgery, University Health Network and McEwen Centre for Regenerative Medicine, Toronto, Ontario, Canada; and Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Stefan O
authors.initials: SO
authors.lastname: Hofer