RIB-MUSCLE PEDICLE FLAP FOR THE REPAIR OF CONGENITAL TRACHEAL STENOSIS

被引:8
作者
WILLNER, A [1 ]
VELEZ, FJ [1 ]
机构
[1] MONTEFIORE MED CTR,ALBERT EINSTEIN COLL MED,DEPT OTOLARYNGOL HEAD & NECK SURG,BRONX,NY 10467
关键词
CONGENITAL TRACHEAL STENOSIS; RIB-MUSCLE PEDICLE FLAP;
D O I
10.1177/000348949410300804
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Congenital tracheal stenosis (CTS) is an uncommon congenital anomaly that presents early in life with symptoms of biphasic strider. Most cases require surgical correction. Techniques have included dilation, resection of the involved segment, and tracheoplasty. Today pericardium and costal cartilage are the most frequently used materials for tracheoplasty, but patients still often encounter problems with the graft, with the procedure, or with late complications. This preliminary study was undertaken to determine the feasibility of a rib-intereostal muscle pedicle flap for the treatment of CTS. Tracheoplasties were performed on seven 3.5- to 5.5-kg piglets with a pedicled segment of the right fourth rib via a lateral thoracotomy incision. The method was found to be technically feasible, and pedicles of greater than 2.5 cm were easily developed. The repair provided good structural support and an airtight seal at high ventilator pressures. Histologic examination after 2 weeks showed the flap to be incorporating into the native trachea and to be without degenerative changes. This ''vital'' composite flap has several real and theoretic advantages over current methods of repair and may prove to be valuable in the treatment of CTS. The clinical application of this myo-osseous pedicle graft in the treatment of patients with stenoses not amenable to surgical resection and primary anastomosis should be explored.
引用
收藏
页码:601 / 608
页数:8
相关论文
共 25 条
  • [1] CONGENITAL TRACHEAL STENOSIS
    BENJAMIN, B
    PITKIN, J
    COHEN, D
    [J]. ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, 1981, 90 (04) : 364 - 371
  • [2] BLUESTONE CD, 1983, PEDIATRIC OTOLARYNGO
  • [3] CONGENITAL STENOSIS OF THE TRACHEA
    CANTRELL, JR
    GUILD, HG
    [J]. AMERICAN JOURNAL OF SURGERY, 1964, 108 (02) : 297 - 305
  • [4] COTTON RT, 1992, OPERATIVE TECHN OTOL, V3, P165
  • [5] TRACHEOBRONCHIAL OBSTRUCTIONS IN INFANTS AND CHILDREN - EXPERIENCE WITH 45 CASES
    DELORIMIER, AA
    HARRISON, MR
    HARDY, K
    HOWELL, LJ
    ADZICK, NS
    [J]. ANNALS OF SURGERY, 1990, 212 (03) : 277 - 289
  • [6] REDUCED TRACHEAL GROWTH AFTER RECONSTRUCTION WITH PERICARDIUM
    DYKES, EH
    BAHORIC, A
    SMITH, C
    KENT, G
    FILLER, RM
    [J]. JOURNAL OF PEDIATRIC SURGERY, 1990, 25 (01) : 25 - 29
  • [7] TRACHEOPLASTY - A NEW OPERATION FOR COMPLETE CONGENITAL TRACHEAL STENOSIS
    EIN, SH
    FRIEDBERG, J
    WILLIAMS, WG
    REARON, B
    BARKER, GA
    MANCER, K
    [J]. JOURNAL OF PEDIATRIC SURGERY, 1982, 17 (06) : 872 - 878
  • [8] INTERCOSTAL MUSCLE AND MYO-OSSEOUS FLAPS IN DIFFICULT PEDIATRIC THORACIC PROBLEMS
    GUSTAFSON, RA
    HRABOVSKY, EE
    [J]. JOURNAL OF PEDIATRIC SURGERY, 1982, 17 (05) : 541 - 545
  • [9] HAMELINK MC, 1989, HEART LUNG, V18, P178
  • [10] HEIMANSOHN DA, 1991, J THORAC CARDIOV SUR, V102, P710