Autologous Tracheal Cartilage Composite Graft for a Subglottic Defect after Laryngotracheal Resection for Invasive Papillary Thyroid Carcinoma

Abstract

Objective: To present a function-preserving surgical technique of post-laryngotracheal resection reconstruction of the subglottic airway using autologous tracheal cartilage composite graft.
 Methods:
 Design: Case Report
 Setting: Tertiary Government Training Hospital
 Participants: One
 Results: A 77-year-old woman diagnosed with papillary thyroid carcinoma with laryngotracheal invasion underwent total thyroidectomy with laryngotracheal resection. The tracheal defect was reconstructed using end-to-end anastomosis of the trachea to the remaining cricoid. The cricoid (subglottic) defect was repaired using the harvested tracheal cartilage with mucosa. Post-operatively, the patient was maintained on nasogastric tube feeding and tracheostomy tube for 2 weeks. Subsequently, the nasogastric tube and tracheostomy tube were removed and the patient tolerated oral feeding without any airway problem. The last follow-up of the patient was 6 months post-operatively without complications.
 Conclusion: Autologous tracheal cartilage may be a potentially promising composite graft for reconstruction of the cricoid (subglottic) defect in a patient following laryngotracheal resection for invasive papillary thyroid carcinoma of the larynx and trachea.
 
 Keywords: tracheal composite graft; laryngotracheal resection; crico-tracheal anastomosis; papillary thyroid carcinoma; subglottic defect