Sternal Trach | Figure 1
Sternal Trach
Pt with history of glottic squamous cell carcinoma. Tx then developed bilateral glottic mass with extension into subglottis. Total laryngectomy, pharyngectomy, and cervical esophagectomy performed. Later developed pharyngocutaneous fistula above the stoma.
Pt now s/p sternal "trach". Site was created by drilling through sternum, inserting free flap with vein and artery intact from forearm. Site is actively vascularized.
Pt chance of survival without procedure 0%. Survival with procedure 25%.
Fistula removal, neck dissection and flap created by head and neck cancer team.
Sternal drill site created by cardiac surgeon.
Diagnosis added by author
Recurrent squamous cell carcinoma
The author made an update to this case
Update 1
I attempted to add a pic of his xray but have not been able to. (If there is a way, please let me know). He is being discharged to home health. The plan is to give him several months to heal and regain strength, then reevaluate for potential revisions to the procedure.