Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan 48202, USA.
Head Neck. 2013 Aug;35(8):E254-7. doi: 10.1002/hed.23088. Epub 2012 Sep 18.
Single-stage procedures for reconstruction of large cricotracheal defects have been limited in success and malignant immature teratomas in the larynx of an adult have never been reported.
This was a case report and literature review. A 27-year-old man presented with 2 weeks of new-onset stridor and was found to have a mass obstructing 80% of the subglottis and trachea. He underwent a noncircumferential partial cricotracheal resection with a resultant 7-cm luminal defect, followed by osteocutaneous radial forearm flap semi-rigid reconstruction. A novel technique was used to allow a functional and patent airway, which may be applied to other partial luminal reconstructive defects. Postoperatively, the patient was decannulated and has good speech quality and swallowing function. This work was performed at the Henry Ford Health System. This project was reviewed and was granted full approval by the Henry Ford Health System Institutional Review Board.
This is the first reported case of malignant immature teratoma to involve the larynx, trachea, and recurrent laryngeal nerve in an adult patient, and the first single-stage technique described to use free tissue transfer without prefabrication for a 7-cm airway defect.
重建大环状软骨缺陷的单阶段手术一直存在成功率限制，且成人喉内恶性未成熟畸胎瘤从未有过报道。
本案例为病例报告并结合文献复习。一名 27 岁男性因新出现的喘鸣 2 周就诊，检查发现声门下和气管 80%被肿块阻塞。他接受了非环状部分环状软骨切除术，导致 7cm 管腔缺损，随后进行了带骨皮的桡侧前臂游离皮瓣半刚性重建。采用一种新的技术来形成一个功能和通畅的气道，该技术可应用于其他部分管腔重建缺陷。术后，患者拔管，言语质量和吞咽功能良好。本研究在亨利福特健康系统进行。本项目经过审查，获得了亨利福特健康系统机构审查委员会的全面批准。
这是首例报道的成人喉、气管和喉返神经恶性未成熟畸胎瘤病例，也是首例描述的在无需预制的情况下，使用游离组织移植进行 7cm 气道缺损的单阶段技术。
