We have developed a new surgical method for repairing
tracheobronchomalacia. In experiments on dogs we tried external fixation of
Marlex mesh (Bard Cardiosurgery Division, Bellerica, Mass.) on the trachea. We first made models of
tracheomalacia by making fractures or resections in intrathoracic tracheal cartilages and then made an external fixation of
Marlex mesh on the malacic segments of the trachea. In 11 dogs
Marlex mesh was sutured onto the trachea with absorbable thread. The trachea was firmly supported after 2 to 6 months, compared with three controls in which no external fixation was made. However, mucosal defects associated with
ischemia caused by the
suture developed in four of the 11. In 13 more dogs
Marlex mesh was bonded to the trachea with
fibrin glue. After 3 to 8 months the supporting strength of the trachea increased up to the level of the normal trachea. There was no evidence of
inflammation or of mucosal defects. Therefore
Marlex mesh was applied to a 44-year-old-man who had experienced frequent attacks of
cough syncope. After the operation the attacks of
cough syncope and collapsing of his airway disappeared completely.