Delaere Pierre R, Vertriest Rudolph, Hermans Robert
Department of Otorhinolaryngology-Head and Neck Surgery, St Rafael University Hospital, Catholic University Leuven, Belgium.
Ann Otol Rhinol Laryngol. 2003 Aug;112(8):678-82. doi: 10.1177/000348940311200805.
Chondrosarcoma of the cricoid cartilage poses difficult therapeutic challenges. The tumor necessitates resection of parts of the cricoid cartilage with a resulting defect that is difficult to repair. We wanted to improve the functional outcome after resection of a lateralized chondrosarcoma by applying the technique of tracheal autotransplantation. The technique involves a 2-stage procedure, because the trachea needs at least 2 weeks for revascularization. Tracheal revascularization is the first stage, and is accomplished by wrapping the trachea in vascularized fascia (radial forearm). The second stage, performed after 14 days, consists of a hemilaryngectomy with tracheal autotransplantation. A case of a large unilateral chondrosarcoma of the cricoid cartilage with involvement of 1 cricoarytenoid joint is reported. The tumor was removed by hemicricohemilaryngectomy. After 2 weeks of tracheal revascularization, the cervical trachea was used to repair the laryngeal defect. The tumor was completely resected, and all laryngeal functions (swallowing, voice, respiration without tracheostomy) were restored. The patient remains tumor-free after a follow-up period of 3 years. Tracheal autotransplantation improves the functional treatment of lateralized chondrosarcomas of the cricoid cartilage.
环状软骨软骨肉瘤带来了艰巨的治疗挑战。该肿瘤需要切除部分环状软骨，从而造成难以修复的缺损。我们希望通过应用气管自体移植技术来改善外侧型软骨肉瘤切除后的功能结局。该技术包括一个两阶段的过程，因为气管至少需要2周时间进行血管重建。气管血管重建是第一阶段，通过将气管包裹在带血管蒂的筋膜（桡侧前臂）中来完成。第二阶段在14天后进行，包括半喉切除术和气管自体移植。报告了1例累及1个环杓关节的环状软骨大型单侧软骨肉瘤病例。通过半环状软骨半喉切除术切除肿瘤。气管血管重建2周后，使用颈段气管修复喉部缺损。肿瘤被完全切除，所有喉部功能（吞咽、发声、无需气管造口即可呼吸）均得以恢复。随访3年后，患者无肿瘤复发。气管自体移植改善了外侧型环状软骨软骨肉瘤的功能治疗。
