Reconstructive surgery after hemilaryngectomy for recurrent thyroid cancer using a free jejunal patch-graft.

Abstract

This case report describes the third recurrence of a poorly differentiated follicular thyroid carcinoma that led to destruction of the thyroid cartilage. Curative surgery required hemilaryngectomy. Because of three previous operations (including neck dissection) and repeated external radiation, the typical laryngoplastic procedures and muscle flaps were not applicable. We therefore employed a stretched jejunal patch to cover the defect so that the neoglottic slit rendered respiration and phonation possible. Thus this approach resulted in functional reconstruction and obviated the need for a tracheostoma. We conclude that the use of a jejunal transplant represents a viable alternative to local reconstruction, particularly in cases complicated by previous surgery and external radiation.