TY - JOUR
T1 - The use of a prefabricated radial forearm free flap for closure of a large tracheocutaneous fistula
T2 - A case report and review of the literature
AU - Royer, Allison K.
AU - Royer, Mark C.
AU - Ting, Jonathan Y.
AU - Weisberger, Edward C.
AU - Moore, Michael
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Introduction: The closure of complex tracheocutaneous fistulae is a surgical challenge. We describe a staged approach for management of a patient with a large tracheocutaneous fistula in the setting of prior surgery and local radiation therapy. Case presentation: A 66-year-old Caucasian man who had undergone prior surgery and radiation therapy to the lower neck presented to our hospital for treatment of a large tracheocutaneous fistula that had developed with an adjacent area of tracheal stenosis. A prefabricated composite graft made up of an inner mucosal lining (buccal mucosa), a central cartilage structure (conchal cartilage), and external skin lining was constructed on the patient's distal volar forearm and subsequently harvested in a staged fashion. This graft was transferred as a free flap and successfully used to close the patient's defect following revascularization. Sixty months after surgery, the patient had no airway compromise or new dysphonia. Conclusions: The use of a prefabricated mucosally lined composite graft can allow for successful closure of large tracheocutaneous fistulae, even in the setting of prior radiation therapy.
AB - Introduction: The closure of complex tracheocutaneous fistulae is a surgical challenge. We describe a staged approach for management of a patient with a large tracheocutaneous fistula in the setting of prior surgery and local radiation therapy. Case presentation: A 66-year-old Caucasian man who had undergone prior surgery and radiation therapy to the lower neck presented to our hospital for treatment of a large tracheocutaneous fistula that had developed with an adjacent area of tracheal stenosis. A prefabricated composite graft made up of an inner mucosal lining (buccal mucosa), a central cartilage structure (conchal cartilage), and external skin lining was constructed on the patient's distal volar forearm and subsequently harvested in a staged fashion. This graft was transferred as a free flap and successfully used to close the patient's defect following revascularization. Sixty months after surgery, the patient had no airway compromise or new dysphonia. Conclusions: The use of a prefabricated mucosally lined composite graft can allow for successful closure of large tracheocutaneous fistulae, even in the setting of prior radiation therapy.
KW - Radial forearm free flap
KW - Tracheocutaneous fistulae
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UR - http://www.scopus.com/inward/citedby.url?scp=84945972902&partnerID=8YFLogxK
U2 - 10.1186/s13256-015-0728-z
DO - 10.1186/s13256-015-0728-z
M3 - Article
C2 - 26520064
AN - SCOPUS:84945972902
VL - 9
JO - Journal of Medical Case Reports
JF - Journal of Medical Case Reports
SN - 1752-1947
IS - 1
M1 - 251
ER -