Airway repair with pedicled composite grafts--clinical experience.

In particular surgical situations, part of the airway wall may have to be excised for different reasons, perhaps because of a large tumor or extensive scar tissue. The repair of large laryngotracheal defects, impossible to reconstruct with segmental resection and end-to-end anastomosis or to repair with existing adjacent tissue, is a challenge. A prerequisite for reconstruction of such defects is a graft composed of well-vascularized mucosal lining and a supportive framework to keep the airway patent. A three-stage procedure, based on the creation of an autogenous mucosal cyst, has been developed and used clinically in a series of patients. The three most recent patients who have undergone reconstruction with pedicled muscle Proplast mucosa grafts are presented. In two of the patients, large unilateral laryngeal tumors were removed and the third had a large patent tracheostoma.