A case of thyroid cancer, resection of trachea and reconstructed tracheal wall with costal cartilage

DOI Web Site 8 References
  • Yamatodani Takashi
    Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine
  • Sugiyama Kenichi
    Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine
  • Okamura Jun
    Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine
  • Takizawa Yoshinori
    Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine
  • Takahashi Goro
    Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine
  • Misawa Kiyoshi
    Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine
  • Mizukami Takahide
    Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine
  • Mineta Hiroyuki
    Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine

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Other Title
  • 広範囲気管合併切除後に二期的再建を行った甲状腺癌症例

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Abstract

We report on a case in which thyroid cancer infiltrated the trachea, and we performed a segmental resection of the trachea and reconstructed the tracheal wall.<br>Case: A 25-year-old male who was diagnosed with papillary cancer in the right lobe of the thyroid gland and underwent surgery at another hospital. During surgery, the tumor was found to have spread to the trachea and the right recurrent laryngeal nerve. Complete resection was not possible, thus he was referred to our department. During the initial examination, it was confirmed that the right vocal cord was fixed at the median position. A preoperative CT scan revealed a tumor compressed on the right side of the trachea.<br>Surgery and post-operation: We removed the residual tumor, performed a partial resection of the trachea, and reconstructed the tracheal wall with costal cartilage as a two-stage operation. We resected about six tracheal rings, going as far as the membranous part on the right side, as far as one-third of the tracheal rings on the left, and coming above from the cricoid cartilage. We collected costal cartilage, cut one section into two vertical pieces and created a cartilage plate, with one piece forming a lateral tracheal wall, and buried the remainder under the skin at the left side of the tracheostomy to be used later to rebuild the anterior tracheal wall. Approximately six months later, we performed surgery to close the tracheostomy. We created a cutaneous flap that included the cartilage buried under the skin and closed the anterior tracheal wall. We closed the incision by extending flaps from both sides of the neck. After surgery, the shape of the trachea was good, the patient had no trouble breathing, and his phonation was good.

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