Tracheal Reconstruction With a Clavicle-attached Sternocleidomastoid Muscle Flap Tolerant to Positive Pressure Ventilation

This paper discusses a surgical technique to repair a persistent tracheocutaneous fistula (TCF) in a patient who needs noninvasive positive pressure ventilation (NPPV). The patient had extensive damage to their trachea from multiple previous surgeries and the continuous pressure from the NPPV. The surgeons used a sternocleidomastoid (SCM) muscle flap attached to a piece of the clavicle bone to rebuild the damaged trachea. This flap provided both support and rigidity to the trachea, allowing the patient to continue using NPPV without complications. Eight years after the surgery, the reconstructed trachea remained stable and leak-free, demonstrating the long-term success of this technique. This method may be a good option for similar cases where patients require ongoing NPPV after tracheostomy.

• 1
  A clavicle-attached pedicled sternocleidomastoid muscle (SCM) flap can be used to reconstruct the tracheal wall in patients with extensive tracheal cartilage defects.
• 2
  The reconstructed trachea was able to withstand positive pressure ventilation without air leaks or deformities.
• 3
  After 8 years, the transplanted clavicle segment had fused with the anterior tracheal wall, preserving the structural integrity of the area.