A New Method for Plastic Closure of an Extensive Laryngotracheal Defect

Document Type : Case Report


1 Depaerment of Ear, Nose and Throat Diseases, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

2 Institute of Photonic Technologies, Federal Scientific Research Centre ‘Crystallography and Photonics’of Russian Academy of Sciences, Troitsk, Moscow 142190, Russia.


Elimination of extensive defects of the larynx and trachea by using musculoskeletal plastics without the use of supporting materials is not always sufficient. Laser modeling of cartilage tissue is a promising technique in modern medicine.
Case Report:
This article presents a new method for plastic closure of an extensive defect in the larynx and trachea with the help of costal auto-cartilage modeled by an erbium fiber laser with wavelength of 1.56 μm.
The presented method allows us to restore the anatomical integrity of the respiratory tract at the final stage of surgical treatment of patients with chronic combined laryngeal and tracheal stenosis. Presented own clinical observation.


Main Subjects

  1. Lewis S, Earley M, Rosenfeld R, Silverman J. Systematic review for surgical treatment of adult and adolescent laryngotracheal stenosis. Laryngoscope. 2016;127(1):191–98. https://doi:10. 1002/ lary.26151
  2. Remacle M, Eckel HE. Surgery of larynx and trachea. Berlin: Springer, 2010. P. 308
  3. Milanov NO, Gudovsky LM, Parshin VD, Trofimov EI. Microsurgical autoplasty of extensive tracheal defects. Annally plasticheskoi rekonstruktivnoi i esteticeskoi khirurgii. 1998;(2):   9–17.
  4. Scales JT. Tissue reactions to synthetic materials. Proc R Soc Med. 1953;46(8):647–52
  5. Silva AB, Lusk RP, Muntz HR. Update on the use of auricular cartilage in laryngotracheal reconstruction. Ann Otol Rhinol Laryngol. 2000; (109): 343–47. https://doi:10.1177/0003489400109 00401
  6. Pogodina AN, Shibaev EU, Rabadanov KM. et al. Methods of microsurgical autologous tissue transplantation: clinical observation. Transplanto- logiya. 2010;(2)35–7. https://doi:10. 23873/2074-0506-2010-0-2-35-37


  1. Terra RM, Minamoto H, Carneiro F. et al. Laryngeal split and rib cartilage interpositional grafting: treatment option for glottic/subglottic stenosis in adults. J Thoracic Cardiovascular Surgery. 2009;137(4):818–23. https://doi: 10. 1016/ j. 2008.08.035
  2. Mareev OV, Starostina SV, Shuvalova LV. A method of treatment chronic paralytic stenosis of larynx 2006.  Patent of the Russian Federation RU2284773
  3. Svistushkin VM, Starostina SV, Selezneva LVet al. А method for eliminating laryngotracheal defect in patients with chronic paralytic stenosis oflarynx 2018. Patent of the Russian Federation RU 2675022 C1
  4. Lewis S, Earley M, Rosenfeld R et al. Systematic review for surgical treatment of adult and adolescent laryngotracheal stenosis. The Laryngoscope 2017; 127(1):191-198. https:// doi.org/10.1002/lary.26151
  5. Mohan VK, Kashyap L, Verma S. Life threatening subcutaneous emphysema following surgical repair of tracheocutaneous fistula. Paediatr Anaesth 2003; 13(4):339–34. https://doi.org/10. 1046/j.1460-9592.2003.01040.x
  6. Selezneva LV. The current views of the problem of the plastic correction of the laryngo-tracheal defects in the patients presenting with combined laryngeal stenoses. Vestnik otorinolaringologii 2017;1:73-77. https://org/10. 17116/otorino 201782173-77
  7. Rich JT, Gullane P. Current concepts in tracheal reconstruction. Current opinion in otolaryngology & head and neck surgery 2012;20(4):246-53. https://doi.org/10.1097/MOO.0b013e328355580e
  8. Aidonis A et al. Management of tracheal stenosis with a titanium ring and nasal septal cartilage. Eur ArchOtorhinolaryngol 2002;259:404–408. https:// doi. org/1007/s00405-002-0483-9
  9. Reshul’skiy SS. The use of autograft from the hyoid bone during chronic laryngeal stenosis. Abstract of thesis, 2012, 29 p. Russian Federal Center of otorhinolaryngology.
  10. Baum O, Soshnikova Yu, Sobol E et al. Laser Reshaping of Costal Cartilage for Transplantation. LaserSurgeryMedicine 2011;43(6):511–515.https:// doi.org/10.1002/lsm.21077
  11. Sobol’ E, Baum O, Alexandrovskaya Yu et al (2017). Transplantation of rib cartilage reshaped with 1.56 μm laser radiation in rabbits. Proc of SPIE2017: 10039U. https: //doi.org/10. 1117/12. 2266879