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Rotary-door flap in laryngotracheal reconstruction.

A newly described vascularized myocutaneous flap based on the infrahyoid muscles is presented. The blood supply originating at the superior and inferior thyroid arteries is preserved. This flap is rotated axially, 180 degrees, to augment and resurface the lumen of the stenosed airway. Stenting is achieved by means of a silicone T tube topped by a custom-carved laryngeal stent. Hyoid transposition may be included when required. We successfully reconstructed 15 cases of laryngotracheal stenosis by this method. The regional flap provides a dependable, readily applicable technique for reconstruction of difficult laryngotracheal stenoses.