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Stair‐step tracheal repair: Surgical technique
Author(s) -
Sims John R.,
O'Malley Quinn F.,
Spaulding Sarah L.,
Yue Lauren E.,
Urken Mark L.
Publication year - 2020
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26173
Subject(s) - medicine , cricoid cartilage , surgery , recurrent laryngeal nerve , arytenoid cartilage , dissection (medical) , airway , thyroid cartilage , neck dissection , thyroid carcinoma , larynx , carcinoma , thyroid
Typical surgical treatment for invasive thyroid carcinoma at the level of the cricoid substantially reduces surrounding cartilaginous support and risks damage to the recurrent laryngeal nerve (RLN). We present a novel tracheal reconstructive technique that minimizes this injury risk. A 72‐year‐old man with recurrent invasive thyroid carcinoma underwent cricotracheal resection and reconstruction using a stair‐step approach. Diseased cartilage was removed by a left hemitracheal and hemicricoid resection. A portion of normal trachea was also resected on the contralateral right side, removing the third and fourth hemitracheal rings, to close the defect with a sliding tracheoplasty and avoid dissection near the right cricothyroid joint on the side of the functioning RLN. The trachea was elevated superiorly and reanastomosed to the cut margin of the cricoid. This novel stair‐step approach to tracheal reconstruction offers reduced risk of injury to the contralateral RLN while still establishing a patent airway.