Rib Cartilage Harvest for Laryngotracheal Reconstruction

Harvest of rib cartilage graft for use in pediatric laryngotracheal reconstruction

When an anterior or posterior cartilage graft is needed to reconstruct a pediatric airway with subglottic stenosis. This is a much more robust cartilage graft compared to thyroid ala, septal, or auricular cartilage as these do not typically provide enough structural support.

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Bovie

The harvest of this graft must be performed in a sterile environment with separate surgical equipment used instead of using the same equipment that was used for the neck to avoid cross-contamination

See laryngotracheal reconstruction video

The incision is typically made in the inframammary crease and dissection taken down to perichondrium of the rib. The costochondral junction is located utilizing a needle. Periosteum is preserved on one side of the graft during the harvest. The length of graft required is pre-determined by measurements of the airway prior to starting the cartilage harvest.

Care must be taken to avoid violating the pleural space during dissection as this could potentially lead to a pneumothorax.

Care must be taken to avoid violating the pleural space during dissection as this could potentially lead to a pneumothorax.

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