Cricotracheal reconstruction with free radial forearm flap and titanium mesh.

Abstract

Reconstruction after partial cricotracheal resection is technically demanding and is seldom reported in literature. The purpose of this study was to report a technique of reconstruction of such a defect with a radial forearm flap supported by a titanium mesh. A 75-year-old man who was diagnosed with a case of papillary carcinoma thyroid, underwent excision of the tumor with a partial cricotracheal resection. The defect was reconstructed with a free radial forearm flap with fascia suspended on a titanium mesh. At a follow-up of 6 months after treatment, the patient has normal nasal breathing and an acceptable voice. This reconstructive technique enabled us to maintain the integrity of the subglottic airway. Our technique was unique in that we used the skin-lined part of the radial forearm flap to line the airway and the fascia to cover the titanium mesh outside, thereby preventing plate exposure.