Fascia Temporalis Free Flap for Cricotracheal Reconstruction: A Novel Approach Bertrand Baujat, MD, PhD, Samuel Struk, MD, Maria Lesnik, MD, MS, Olivier.

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Fascia Temporalis Free Flap for Cricotracheal Reconstruction: A Novel Approach Bertrand Baujat, MD, PhD, Samuel Struk, MD, Maria Lesnik, MD, MS, Olivier de Crouy Chanel, MD, MS, Jonathan Barbut, MD, Marine Lefevre, MD, Sophie Périé, MD, PhD, Jean Lacau St. Guily, MD, PhD The Annals of Thoracic Surgery Volume 104, Issue 3, Pages 1040-1046 (September 2017) DOI: 10.1016/j.athoracsur.2017.02.078 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Surgical procedure. (A) Tracheal defect after resection of the stenosis in patient 1. (B) The free temporoparietal fascia flap is harvested based on the superficial temporal artery and vein. (C) Costal cartilages are trimmed into strips longitudinally. (D) After microvascular anastomoses in the neck, the temporoparietal fascia flap is spread on top of the tracheal defect and stitched with the costal cartilage framework on the remaining lateral side of the trachea. The Annals of Thoracic Surgery 2017 104, 1040-1046DOI: (10.1016/j.athoracsur.2017.02.078) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Surgical procedure in patient 3: (A) preoperative view, (B) exposition of the defect, and (C) view of the reconstruction. The Annals of Thoracic Surgery 2017 104, 1040-1046DOI: (10.1016/j.athoracsur.2017.02.078) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Computed tomography (CT) scans show (A) frontal and (B) sagittal views of the stenosis preoperatively and (C) frontal and (D) sagittal views of the neotrachea 9 months after the reconstruction. The stenosis was successfully dilated. The Annals of Thoracic Surgery 2017 104, 1040-1046DOI: (10.1016/j.athoracsur.2017.02.078) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Biopsy specimens performed by tracheoscopy in the middle of the reconstructed area show malpighian and respiratory epithelium (hematoxylin and eosin stain at original magnification ×100). The Annals of Thoracic Surgery 2017 104, 1040-1046DOI: (10.1016/j.athoracsur.2017.02.078) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions