LARYNGOTRACHEAL RECONSTRUCTION WITH TRACHEAL PATCH ALLOGRAFTS

The capacity of tracheal allotransplants in providing optimal tissues for laryngotracheal repair was studied in an animal model, Segments of cervical trachea could be revascularized completely when wrapped in a receptor fascia flap in immunosuppressed rabbits, In phase I the reva scularized tracheas were incised longitudinally and transformed into f our different patches after a 14-day revascularization period, The blo od supply toward the four patch designs was examined with angiography, The patch designs that showed a vascularization over at least 75% of their mucosal surface area were used in phase II to reconstruct extend ed anterior laryngotracheal defects, The morphologic characteristics o f the tracheal patches when used inside laryngotracheal defects were s tudied using radiographic, angiographic, and histologic techniques, Th e revascularized allograft patches that were fully supported by trache al cartilage were most suitable to repair anterior laryngotracheal def ects in this animal study, This model allowed us to define the tissue characteristics necessary for obtaining a combination of primary heali ng and optimal luminal support in the repair of laryngotracheal defect s.