Norbert Pallua1, Timm Phillip Wolter. 1. Department of Plastic and Reconstructive Surgery, Hand Surgery, Burn Center, University Hospital of the RWTH, Pauwelsstrasse 30, 52074, Aachen, Germany. npallua@ukaachen.de
Abstract
PURPOSE: Following long-term tracheostomy, reconstruction of the suprasternal notch and coverage of tracheocutaneous fistulas can be challenging. Often, aesthetic results are secondary to functional outcome. In this article, we propose a defect classification and a treatment algorithm using the tunneled supraclavicular artery island flap for functional and aesthetic reconstruction. METHODS: Twelve patients requiring complete or partial closure of a tracheocutaneous fistula or soft tissue deficit reconstruction were treated with this pedicled flap. Support for the anterior tracheal wall was achieved by including fascia or bone into the flap. RESULTS: Functional outcome was excellent, and suprasternal notch correction was achieved with good texture match. Donor sites could be closed primarily in every case. All flaps healed uneventfully, Long-term follow-up computed tomography scans demonstrated vital bone chips. CONCLUSIONS: The proposed classification and treatment algorithm provides a structured approach to a successful surgical treatment of this complex condition.
PURPOSE: Following long-term tracheostomy, reconstruction of the suprasternal notch and coverage of tracheocutaneous fistulas can be challenging. Often, aesthetic results are secondary to functional outcome. In this article, we propose a defect classification and a treatment algorithm using the tunneled supraclavicular artery island flap for functional and aesthetic reconstruction. METHODS: Twelve patients requiring complete or partial closure of a tracheocutaneous fistula or soft tissue deficit reconstruction were treated with this pedicled flap. Support for the anterior tracheal wall was achieved by including fascia or bone into the flap. RESULTS: Functional outcome was excellent, and suprasternal notch correction was achieved with good texture match. Donor sites could be closed primarily in every case. All flaps healed uneventfully, Long-term follow-up computed tomography scans demonstrated vital bone chips. CONCLUSIONS: The proposed classification and treatment algorithm provides a structured approach to a successful surgical treatment of this complex condition.
Authors: Frank Riedel; Ulrich Reinhart Goessler; Stephan Grupp; Gregor Bran; Karl Hörmann; Thomas Verse Journal: Auris Nasus Larynx Date: 2005-09-23 Impact factor: 1.863
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