Abstract
The aim of this report is to describe our new technique to simultaneously reconstruct a medium-sized tracheal defect using a modified infrahyoid myocutaneous (IHMC) flap in a patient of thyroid cancer with tracheal invasion.
The patient was a 55-year-old male patient with papillary thyroid carcinoma occupying the left lobe of the thyroid, showing tracheal invasion. After making a collar skin incision that was convex toward the sternum in the anterior cervical region, we prepared bilateral IHMC flaps. Total thyroidectomy with central neck dissection and partial tracheal resection was performed, and a tracheal defect developed on the left side of the tracheal cartilage, from the lower edge of the cricoid cartilage to the third tracheal ring (3.5cm×3.0cm). A skin island of the same size was created at the most distal part of the IHMC flap, and the tracheal defect was repaired by turning the skin island over toward the trachea. The postoperative course was uneventful, and the reconstructed part turned out to be as wide as the normal tracheal lumen on CT imaging performed eight months after the surgery.
The modified IHMC flap can be a suitable flap for repairing small to medium-sized defects of the trachea, without tracheostomy.
