Nasal Septal Cartilage as Anterior Cap-Graft for Open Tracheoplasty in Cases for Laryngotracheal Stenosis: Our Initial Experience

Nirali Chauhan; Rahul Gupta; Ishita Akshay Shah; Raj Patel; R G Aiyer

doi:10.1007/s12070-023-04065-w

Nasal Septal Cartilage as Anterior Cap-Graft for Open Tracheoplasty in Cases for Laryngotracheal Stenosis: Our Initial Experience

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3671-3678. doi: 10.1007/s12070-023-04065-w. Epub 2023 Jul 14.

Authors

Nirali Chauhan¹, Rahul Gupta¹, Ishita Akshay Shah¹, Raj Patel¹, R G Aiyer¹

Affiliation

¹ Department of E.N.T and Head-Neck Surgery, Govt. Medical College and S.S.G. Hospital, Vadodara, Gujarat India.

PMID: 37974809
PMCID: PMC10646135 (available on 2024-12-01)
DOI: 10.1007/s12070-023-04065-w

Abstract

The aim of our study is to analyze the efficacy of nasal septal cartilage as cap-graft in laryngo-tracheoplasty in cases of Laryngotracheal stenosis. This was a prospective observational study carried out at a tertiary care hospital from March 2020 to March 2023. Total 8 patients who underwent laryngo-tracheoplasty using nasal septal cartilage as anterior Cap-graft were included in the study. Detailed history and clinical evaluation followed by diagnostic Flexible Fiber-optic Laryngoscopy and radiological investigations were done for all patients with post operative follow up for at least 1 year. Our study had maximum patients in age group of 11-30 years with male predominance, unknown compound ingestion being most common cause of intubation which was followed by tracheostomy. All patients had Cotton Mayer Grade III or IV subglottic stenosis. Out of 8 patients, 5 patients are decannulated, 1 patients still have T-tube in-situ whereas 2 patients didn't tolerate decannulation and required re-exploration. No donor site complication was seen during the study period. Nasal septal cartilage is a viable option for being used as anterior cap graft in laryngo-tracheoplasty. It can be a game changer, as can be done by E.N.T surgeon himself. No separate learning skills are required. It's cosmetically better with minimal complications; compared to life threatening complications like pneumothorax on using costal cartilage. Laryngeal framework is preserved as opposed to thyroid alar cartilage graft. Faster healing along with better postoperative donor site recovery are significant advantages.

Keywords: Cap Graft; Laryngo-Tracheoplasty; Post-Intubation; Septal Cartilage Graft; Subglottic Stenosis.

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