Cricotracheal resection for laryngeal invasion by thyroid carcinoma: our experience.

Details

Serval ID
serval:BIB_66DA99E807E4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cricotracheal resection for laryngeal invasion by thyroid carcinoma: our experience.
Journal
European Archives of Oto-rhino-laryngology
Author(s)
Morisod B., Monnier P., Simon C., Sandu K.
ISSN
1434-4726 (Electronic)
ISSN-L
0937-4477
Publication state
Published
Issued date
2014
Volume
271
Number
8
Pages
2261-2266
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
Invasion of the laryngeal framework by thyroid carcinoma requires specific surgical techniques and carries a higher rate of complications that deserve to be highlighted. We reviewed our data from 1995 to 2012 and found six patients with laryngotracheal invasion by thyroid carcinoma. All underwent total thyroidectomy and single-stage cricotracheal resection, plus anterolateral neck dissection. Three had airway obstruction that necessitated prior endoscopic debulking. None of the patients needed a tracheotomy. There were four cases of papillary carcinoma, and two cases of undifferentiated carcinoma. One patient died of complications of the procedure (anastomotic dehiscence and tracheo-innominate artery fistula). Another died 2 months after the procedure from local recurrence and aspiration pneumonia. One case presented recurrence at 15 months, which was managed by re-excision and adjuvant radiotherapy; after 26 months of follow-up, he has no evidence of locoregional recurrence. The three other patients are alive without evidence of disease at 6, 18 and 41 months, respectively. Cricotracheal resection for subglottic invasion by thyroid carcinoma is an effective procedure, but carries significant risks of complications. This could be attributed to the devascularisation of the tracheal wall due to the simultaneous neck dissection, sacrifice of the strap muscles or of a patch of oesophageal muscle layer. We advocate a sternocleidomastoid flap to cover the anastomosis. Cricotracheal resection for subglottic invasion can be curative with good functional outcomes, even for the advanced stages of thyroid cancer. Endoscopic debulking of the airway prior to the procedure avoids tracheotomy.
Pubmed
Web of science
Create date
14/02/2014 15:18
Last modification date
20/08/2019 14:22
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