Posthemicricoidectomy reconstruction with a composite hyoid-sternohyoid osseomuscular flap: the Rethi–Ward technique

Abstract

Our objective was to introduce a new technique for cricoid cartilage reconstruction. A 74-year-old male patient with a history of a 6-month progressively worsening dyspnea was found to have an extensive mass of the left cricoid cartilage. Although the extent of his disease would necessitate total laryngectomy, the patient underwent an open extended left hemicricoidectomy with reconstruction of the defect by a pedicled osseomuscular flap composed of the body of the hyoid bone and the contralateral sternohyoid muscle. Both frozen section and subsequent histopathological evaluation gave the diagnosis of a chondrosarcoma. A Montgomery T-tube was left in place for 3 months and was subsequently replaced by a tracheostomy tube to be removed 1 month later. Six months postoperatively, the patient remains in an excellent respiratory condition. The reconstructed site is patent without any signs of restenosis as up to date. We conclude that our technique appears to be a reliable alternative to total laryngectomy in cases of extended chondrosarcomas, as well as in cases where reconstruction of the cricoid cartilage is mandated. Further follow-up and additional cases are warranted.