m cells and tissue engineering to create, for the first time in man, windpipe (trachea) replacements in adults and a UK child. Although close to death before surgery, he is now well and back at school one year later. Although much work remains to be done, these successes have opened the door to a new future of safe, effective and customized organ and tissue replacements."
The results show that regenerative medicine appears to offer an exciting box of new tools to apply to difficult airway problems.
Invited Karl Storz Lecture Surgical Management of Laryngeal Clefts
Presenter: Noel Garabedian, MD
Date: Saturday, April 30, 2011
Time: 2:00 2:45
Chicago, IL The laryngotracheal cleft is a rare congenital anomaly, first described in 1792 by Richter, it consists of a direct communication between the trachea and oesophagous.
The incidence of this uncommon pathology is 1 in 10,000 to 20,000 births. This incidence is most likely to be underestimated for three reasons: minor laryngeal clefts may be asymptomatic; endoscopic diagnosis is difficult, especially in type 1, the cleft is easily missed and severe clefts could lead to a child's death before the diagnosis.
"Laryngeal clefts are rare and complex pathologies which require a multi-disciplinary approach," said Professor Noel Garabedian, MD. "An early diagnosis and involvement of specialized ORL and anesthetic teams make it possible to decrease dramatically mortality and to improve the functional outcome."
Based on the research for this study, the author arrived at the following guidelines:
Type I cleft with mild symptoms may be managed conservatively except occasional cases.
Type II and III clefts, previously standard surgery was performed by lateral pharyngotomy or anterior laryngofissure. Some authors proposed the use of posterior interposition graft: tibial periosteum, cartilage, fascia temporalis and muscular flap.
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