Laryngo-tracheal autograft operation

Abstract

A case of post-cricoid and posterior hypopharyngeal carcinoma with dysphagia was successfully treated by laryngo-tracheal autograft operation. The posterior parts of the larynx & upper trachea, upper segment of the oesophagus and the adjoining pharynx were resected as a block. The trachea was transected at about the level of the third ring and brought forward to make the permanent tracheostome. The anterior parts of the larynx and the trachea (laryngo-tracheal auto-graft) were dislocated posteriorly and anastomosed with the oesophagus. A split-thickness skin graft, taken from the medial aspect of the right thigh, was used to cover the raw prevertebral area, left after excision of the pharynx and oesophagus. This skin graft formed the posterior pharyngo-oesophageal wall. The lateral margins of the skin graft were stitched to the autograft, thus completing the alimentary tube. The whole reconstruction was performed over a naso-gastric feeding tube.