The sternohyoid myocutaneous flap (rotary door flap) in complex laryngotracheal reconstruction

Abstract

Laryngotracheal stenosis remains a formidable challenge to laryngologists, especially when complex and compounded. The multiple surgical techniques proposed for laryngotracheal reconstruction attest to the difficulties encountered in this procedure. Application of the sternohyoid vascularized myocutaneous flap or rotary door flap, together with judicious postoperative management of the tracheostomy with restricted stenting, can expand the surgical options, shorten the postoperative recovery, and raise the rate of success. This article focuses on explanation of the surgical approach and patient selection and treatment with detailed description of the surgical technique. This surgical approach has been applied in 48 patients with complex stenotic lesions during the past 17 years. Only 2 patients were treatment failures. Good results show the versatility and reliability of this reconstructive method.