Graft healing in laryngotracheal reconstruction: an experimental rabbit model.

The actual sequence of events in graft healing in laryngotracheal reconstruction (LTR) is not well understood. To investigate sequential changes in graft healing, we submitted 21 rabbits to LTR with an anterior auricular cartilage graft. They were immediately extubated after surgery, and no stent was used. Rabbits were painlessly sacrificed at 7 different time periods (0, 1, 2, 3, 4, 6, and 10 weeks after surgery). Cross sections of the larynx and graft were cut and stained with hematoxylin-eosin and trichrome. Epithelialization progressed very rapidly and was complete by 21 days. During the 10 weeks, there was a progressive necrosis and resorption of the original graft cartilage. However, neochondrification progressed very rapidly and resulted in excellent structural support of the graft in the airway. Problems, such as infection and granulation tissue formation, were relatively minor and infrequent.