ORTHOTOPIC LARYNGEAL TRANSPLANTATION - IS IT TIME

The notion of returning phonatory and respiratory function by transpla nting larynges has fascinated and challenged the minds of laryngologis ts for many years. In the past, the problems of revascularization, tis sue rejection, and physiologic vocal fold motion have stymied the succ ess of research in this area. Today, advances in microvascular surgery , graft versus host response, and selective reinnervation have made la ryngeal transplantation a theoretical, if not a practical reality. Des pite this progress, serious ethical and fiscal considerations remain u nresolved. This report will discuss these advances as well as concerns and will present the current UCLA laryngeal physiology laboratory exp erience with canine laryngeal transplantation.