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Closure of a Tracheocutaneous Fistula With a Local Turnover Flap Combined With Pregrafted Palatal Mucosa: A Case Report

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ABSTRACT

Objectives:methods:results:conclusions:: A method of closing a large tracheocutaneous fistula by a combination of a palatal mucosal graft with a turnover adiposal flap is presented. Mucosa of the same size as the tracheal defect was harvested from the hard palate and grafted just caudal to the fistula. After the mucosal graft had taken, a local flap containing the mucosal graft was turned over the tracheal defect facing the mucosa inward of the tracheal lumen. The defect caused by harvesting the flap was closed horizontally. The fistula was closed successfully, and 1 year after the operation, the patient had no airway compromise and the operative scar was inconspicuous. Although the described method is a 2-stage procedure, it can be used to simply and reliably reconstruct the mucosal layer of the tracheal lumen and overlying skin.

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Findings 1 year after surgery. (a) The neck scar is inconspicuous. (b) Computed tomographic scan showing complete closure of the tracheocutaneous fistula without stenosis. (c) Skin graft on the palate is durable, and a full denture could be worn as before.
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Figure 4: Findings 1 year after surgery. (a) The neck scar is inconspicuous. (b) Computed tomographic scan showing complete closure of the tracheocutaneous fistula without stenosis. (c) Skin graft on the palate is durable, and a full denture could be worn as before.

Mentions: It took about 1 hour to carry out each operation. The fistula was closed successfully without complications associated with tracheal air or secretion leakage. The skin graft on the hard palate where the mucosal graft had been harvested had taken. Her frequent cough stopped postoperatively. Twelve months after surgery, the patient refused bronchoscopy, but computed tomographic scan showed successful reconstruction. Her neck scar was inconspicuous, and she was very satisfied with the result (Fig 4).


Closure of a Tracheocutaneous Fistula With a Local Turnover Flap Combined With Pregrafted Palatal Mucosa: A Case Report
Findings 1 year after surgery. (a) The neck scar is inconspicuous. (b) Computed tomographic scan showing complete closure of the tracheocutaneous fistula without stenosis. (c) Skin graft on the palate is durable, and a full denture could be worn as before.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120373&req=5

Figure 4: Findings 1 year after surgery. (a) The neck scar is inconspicuous. (b) Computed tomographic scan showing complete closure of the tracheocutaneous fistula without stenosis. (c) Skin graft on the palate is durable, and a full denture could be worn as before.
Mentions: It took about 1 hour to carry out each operation. The fistula was closed successfully without complications associated with tracheal air or secretion leakage. The skin graft on the hard palate where the mucosal graft had been harvested had taken. Her frequent cough stopped postoperatively. Twelve months after surgery, the patient refused bronchoscopy, but computed tomographic scan showed successful reconstruction. Her neck scar was inconspicuous, and she was very satisfied with the result (Fig 4).

View Article: PubMed Central - PubMed

ABSTRACT

Objectives:methods:results:conclusions:: A method of closing a large tracheocutaneous fistula by a combination of a palatal mucosal graft with a turnover adiposal flap is presented. Mucosa of the same size as the tracheal defect was harvested from the hard palate and grafted just caudal to the fistula. After the mucosal graft had taken, a local flap containing the mucosal graft was turned over the tracheal defect facing the mucosa inward of the tracheal lumen. The defect caused by harvesting the flap was closed horizontally. The fistula was closed successfully, and 1 year after the operation, the patient had no airway compromise and the operative scar was inconspicuous. Although the described method is a 2-stage procedure, it can be used to simply and reliably reconstruct the mucosal layer of the tracheal lumen and overlying skin.

No MeSH data available.


Related in: MedlinePlus