The Autogenous Mucosal Cyst Procedure: Experimental Reconstructive Surgery of the Airway with a New Composite Graft Technique

Autogenous buccal mucosa was transplanted to the pretracheal region in five beagles. Subsequently a cyst developed in which the graft constituted the main part of the cyst wall. After 4 to 13 weeks the cyst was explored and a perforated autogenous cortical bone plate was sutured to its vertex. After a further 5 to 7 weeks the resulting composite graft was sutured to an anterior tracheal window defect. All dogs survived. They did not lose weight. One dog had moderate breathing difficulties during exertion. At bronchoscopy, which was performed in all dogs, no contractions or granulations were seen but the stability of the airway wall in the grafted areas was reduced. These areas were removed after 8 to 15 months and studied by light microscopy, scanning electron microscopy and transmission electron microscopy. The mucosa survived in all cases. Total resorption of the bone graft occurred in all but two cases, in which remnants were found.