The use of a prefabricated radial forearm free flap for closure of a large tracheocutaneous fistula: A case report and review of the literature

Allison K. Royer, Mark C. Royer, Jonathan Y. Ting, Edward C. Weisberger, Michael Moore

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

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.

Original languageEnglish (US)
Article number251
JournalJournal of Medical Case Reports
Volume9
Issue number1
DOIs
StatePublished - Nov 1 2015
Externally publishedYes

Keywords

  • Radial forearm free flap
  • Tracheocutaneous fistulae

ASJC Scopus subject areas

  • Medicine(all)

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