Saman Naficy, MD, Ramon M. Esclamado, MD, Ross A. Clevens, MD, MPH

Success in laryngotracheal reconstruction has been limited, in part, by the lack of an ideal grafting material. Perichondrium is thin, pliable, and highly vascularized and has the ability to generate new cartilage providing rigid support. These qualities make vascularized perichondrium potentially the ideal grafting material for circumferential airway stenosis. A pedicled vascularized flap of auricular perichondrium was used in a rabbit model (n = 39) to reconstruct a near-circumferential tracheal defect without a tracheostomy. A stent was used to support the reconstructed airway for 6 weeks, after which time it was removed by direct laryngoscopy. Animals were observed for an additional 6 weeks prior to sacrifice. Qualitative and quantitative histologic analysis of neochondrogenesis is reported. Vascularized perichondrium and periosteum show promise as potential grafts for reconstruction of circumferential tracheal defects.