First example of airway restoration using cryopreserved aortic allograft after total laryngectomy: CARE case report.

Abstract

Case description: A 70 year-old woman presenting T4aN2cM0 laryngeal carcinoma first underwent total laryngectomy with airway reconstruction by cryopreserved aortic allograft. Six months after chemoradiotherapy, she underwent endoscopic surgery to create a neo-laryngopharynx.

Results: At 13 months after primary surgery, day- and night-time breathing was effectively restored, with a little persistent salivary false passage, and a whispering but comprehensible voice after tracheostomy closure. Swallowing was possible for small amounts of soft food, thanks to sustained rehabilitation, although normal feeding was not achieved. The patient showed no episodes of pneumopathy. General health status was good, with no oncologic relapse.

Discussion: This was the first case of laryngeal replacement by cryopreserved aortic allograft, showing progress in the decades-long aim of final tracheostomy closure. The ultimate objective is to achieve swallowing without false passage, by improving various aspects of surgical technique,without, so far as possible, making the procedures more complex by active airway protection systems.