Kirasirova E.A., Mamedov R.F., Tyutina S.I., Lafutkina N.V., Sotnikova T.N., Rezakov R.A., Frolkina E.A. Use of implantation material based on polytetrafluoroethylene in reconstructive and plastic surgery of the larynx and trachea. Head and neck. Russian Journal. 2023;11(2):8–14
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photographs of patients.
The use of implant materials is frequently required to restore the anterior-lateral parts of the larynx and trachea in order to build the airway wall scaffold in reconstructive plastic surgery of the larynx and trachea with extensive laryngotracheal defects. This is necessary for adequate ventilation of the airways, including for forced breathing and coughing. Peak intratracheal pressure can reach 300 mm Hg. during the glottic closure in certain situations. The implant must tolerate these values to prevent flotation and retraction of the laryngeal and tracheal walls and thus the development of airway stenosis.
Despite the progress in surgical technologies, the search for implant materials continues to be an urgent problem due to the disadvantages manifesting in the intra- and postoperative period when performing airway reconstruction with one or another implant. The article analyzes the effectiveness of treatment of patients with extended laryngotracheal obliteration of the lumen and extensive defects of the lateral and laryngeal walls of the larynx and trachea using a synthetic material based on polytetrafluoroethylene as an implant. The study included 10 patients with an age of 21-39 years and a disease duration of 1-5 years. At the outpatient stage, the necessary clinical, radiation, endoscopic, and functional diagnostic procedures were carried out, after which all patients underwent reconstructive plastic surgery using a polytetrafluoroethylene implant. After the discharge from the hospital, with dynamic outpatient postoperative follow-up, complications resistant to conservative therapy occurred, as a result of which the implant material was removed, followed by successful secondary healing of the surrounding tissues with the adequate fibrosis of the anterior-lateral walls of the larynx and trachea capable of performing a supporting function.
The study showed that the use of material based on polytetrafluoroethylene in reconstructive plastic surgery of the larynx and trachea is promising but requires further research due to the presence of complications that significantly affect the functional results of the operation and the quality of life of patients.
Key words: reconstructive plastic surgery, laryngotracheoplasty, polytetrafluoroethylene, implant, laryngeal-tracheal atresia
Conflicts of interest. The author have no conflicts of interest to declare.
Funding. There was no funding for this study