Abstract
A 62-year-old man was referred to our hospital for evaluation of dysphagia. Bronchoscopy revealed squamous cell carcinoma bulging from the membranous portion of the upper trachea. Paralysis of the left vocal cord resulting from involvement of the recurrent laryngeal nerve was observed. Computed tomographic scan further showed its extention to esophagus and left lobe of thyroid. Subtotal resection of trachea combined with total laryngoesophagectomy and left lobectomy of the thyroid was performed. According to Grillo's procedure, anterior mediasinal tracheostomy at the 4th ring from the carina was made. To avoid massive hemorrhages from the aorta and/or superior vena cava, major pectral musclar and pedicled omental flap from the gastric tube were laid over the tracheal stoma. On the 24th post operative day, infection around the stoma caused its stricture. A silicone tube designed for the indivisual patient, therefore, has been applied to for maintain the patency of the stoma up to the present. The patient's quality of life was adequately compensated using an electronic artifical larynx.
