Autotransplantation of the trachea: experimental evaluation of a reconstructive technique for extended hemilaryngectomy defects.

Vascularized segments of trachea were used to repair extended hemilaryngectomy defects in a rabbit model. The cervical trachea was revascularized in a first stage by a fascia flap. In a second stage, the cervical trachea was isolated and transformed into a patch that could be autotransplanted on a vascular carrier. The patches were used for the reconstruction of hemilaryngectomy defects including half of the cricoid. Two months after transplantation, the vascular and morphologic characteristics of the tracheal patches were examined with silicone dye angiography and magnetic resonance imaging. The tracheal patches showed a reliable blood supply when wrapped in vascularized fascia. The patches provided a functional reconstruction of hemicricolaryngectomy defects. It is concluded that autotransplantation of the trachea should be further explored as a potential means for extending the limits of conservation laryngeal surgery.