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Tracheal reconstruction using composite nasal septal graft in patients with invasive thyroid carcinoma

Published online by Cambridge University Press:  12 November 2014

S Dowthwaite ,
M Friel  and
S Coman
S Dowthwaite*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Gold Coast Hospital, Southport, Queensland, Australia
M Friel
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia
S Coman
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia
*
Address for correspondence: Dr Samuel Dowthwaite, Department of Otolaryngology – Head and Neck Surgery, Gold Coast Hospital, Nerang Street, Southport, QLD 4215, Australia E-mail: [email protected]
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Abstract

Objective:

This paper presents a series of three patients who were identified as having partial thickness involvement of the laryngotracheal complex secondary to invasive, well-differentiated thyroid cancer. These patients were managed with full thickness window resection and reconstruction using a composite nasal septal graft.

Methods:

A review of the Princess Alexandra Hospital database (comprising prospectively collated data) was undertaken to identify patients who had undergone full thickness tracheal resection and reconstruction using a composite nasal septal graft; demographic, operative technique and survival outcome data were collated.

Results:

Three patients had a composite nasal septal graft performed for reconstruction of full thickness laryngotracheal defects following the excision of well-differentiated thyroid cancer. There were no cases of local recurrence after a minimum of 18 months' follow up.

Conclusion:

This paper describes our surgical technique for reconstruction of these defects using a composite nasal septal graft. It also presents data on our three cases to date, in which the technique has been used safely. A discussion of the surgical management of locally invasive, well-differentiated thyroid cancer is provided.

Keywords

Thyroid NeoplasmsTracheaNasal CartilagesNasal SeptumTransplantsOtolaryngology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue S1 , January 2015 , pp. S16 - S20
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Brennan, MD, Bergstralh, EJ, van Heerden, JA, McConahey, WM. Follicular thyroid cancer treated at the Mayo Clinic, 1946 through 1970: initial manifestations, pathologic findings, therapy, and outcome. Mayo Clin Proc 1991;66:11–22Google Scholar
2Hay, ID, McConahey, WM, Goellner, JR. Managing patients with papillary thyroid carcinoma: insights gained from the Mayo Clinic's experience of treating 2,512 consecutive patients during 1940 through 2000. Trans Am Clin Climatol Assoc 2002;113:241–60Google Scholar
3Batsakis, JG. Laryngeal involvement by thyroid disease. Ann Otol Rhinol Laryngol 1987;96:718–19Google Scholar
4Honings, J, Stephen, AE, Marres, HA, Gaissert, HA. The management of thyroid carcinoma invading the larynx or trachea. Laryngoscope 2010;120:682–9CrossRefGoogle ScholarPubMed
5Czaja, JM, McCaffrey, TV. The surgical management of laryngotracheal invasion by well-differentiated papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg 1997;123:484–90CrossRefGoogle ScholarPubMed
6Lipton, RJ, McCaffrey, TV, van Heerden, JA. Surgical treatment of invasion of the upper aerodigestive tract by well-differentiated thyroid carcinoma. Am J Surg 1987;154:363–7Google Scholar
7Ark, N, Zemo, S, Nolen, D, Holsinger, FC, Weber, RS. Management of locally invasive well-differentiated thyroid cancer. Surg Oncol Clin N Am 2008;17:145–55Google Scholar
8Friedman, M. Surgical management of thyroid carcinoma with laryngotracheal invasion. Otolaryngol Clin North Am 1990;23:495–507Google Scholar
9McCaffrey, JC. Aerodigestive tract invasion by well-differentiated thyroid carcinoma: diagnosis, management, prognosis, and biology. Laryngoscope 2006;116:1–11Google Scholar
10Sywak, M, Pasieka, JL, McFadden, S, Gelfand, G, Terrell, J, Dort, J. Functional results and quality of life after tracheal resection for locally invasive thyroid cancer. Am J Surg 2003;185:462–7Google Scholar
11Koike, E, Yamashita, H, Noguchi, S, Yamashita, H, Ohshima, A, Watanabe, S et al. Bronchoscopic diagnosis of thyroid cancer with laryngotracheal invasion. Arch Surg 2001;136:1185–9CrossRefGoogle ScholarPubMed
12Friedman, M, Mayer, AD. Laryngotracheal reconstruction in adults with the sternocleidomastoid myoperiosteal flap. Ann Otol Rhinol Laryngol 1992;101:897–908CrossRefGoogle ScholarPubMed
13East, C, Grant, H, Jones, B. Tracheal reconstruction using a composite microvascular temporoparietal fascia flap and nasal septal graft. J Laryngol Otol 1992;106:741–3Google Scholar
14Drettner, B, Lindholm, CE. Experimental tracheal reconstruction with composite graft from nasal septum. Acta Otolaryngol 1970;70:401–7Google Scholar
15Zohar, Y, Shvilli, I, Laurian, N. Laryngeal reconstruction by composite nasoseptal graft after extended partial laryngectomy. Twelve-year follow-up. Arch Otolaryngol Head Neck Surg 1988;114:868–71Google Scholar
16Krizek, TJ, Kirchner, JA. Tracheal reconstruction with an autogenous mucochondrial graft. Plast Reconstr Surg 1972;50:123–30CrossRefGoogle ScholarPubMed
17Duncavage, JA, Ossoff, RH, Toohill, RJ. Laryngotracheal reconstruction with composite nasal septal cartilage grafts. Ann Otol Rhinol Laryngol 1989;98:581–5Google Scholar
18Cansiz, H, Yener, M, Bozkurt, AK, Demir, A, Demirkaya, A, Sekercioglu, N. Surgical treatment of laryngeal tumors with subglottic extension and tracheal tumors with composite nasal septal cartilage graft: technique and outcome. Auris Nasus Larynx 2008;35:363–8Google Scholar
19Laurian, N, Zohar, Y, Turani, H. Histologic findings in a larynx reconstructed by a nasoseptal autograft after partial laryngectomy. Laryngoscope 1983;93:1481–2CrossRefGoogle Scholar
20Zohar, Y, Hadar, H, Laurian, N. Computed tomography evaluation of the nasal septal reconstructed larynx. Head Neck Surg 1985;7:357–64Google Scholar
21Bozkurt, AK, Cansiz, H. Tracheal reconstruction with autogenous composite nasal septal graft. Ann Thorac Surg 2002;74:2200–1Google Scholar