We report a new technique for treatment of tracheomalacia or tracheal compression caused by the innominate artery, utilized
in two patients with neuromuscular disorders. Both cases developed a chest deformity in the setting of severe scoliosis. Computed
chest tomography and fiberoptic bronchoscopy showed that the cervical trachea was compressed between the innominate artery
and the cervical spine in the setting of deformity of the thoracic cavity. Both patients required prolonged mechanical ventilation
prior to the operative procedure. To relieve compression by the innominate artery, the superior mediastinum was exposed by
resection of part of the manubrium allowing a greater space, and external stenting of the cervical trachea with a reinforcing
autologous cartilage graft and tracheopexy, as well as anterior suspension of the innominate artery with a sternohyoid muscle
flap were carried out. Both patients were successfully weaned from prolonged mechanical ventilation. Resection of the manubrium
sterni, tracheal stenting with rib segments and use of the strap muscle to elevate the innominate artery off of the trachea
offer potential long-term release of airway obstruction.
Keywords Tracheomalacia - Thoracic deformity - Innominate artery - Reinforcement - Suspension