Skip to main content Accessibility help

Tracheal reconstruction using composite nasal septal graft in patients with invasive thyroid carcinoma

  • S Dowthwaite (a1), M Friel (a2) and S Coman (a2)



This paper presents a series of three patients who were identified as having partial thickness involvement of the laryngotracheal complex secondary to invasive, well-differentiated thyroid cancer. These patients were managed with full thickness window resection and reconstruction using a composite nasal septal graft.


A review of the Princess Alexandra Hospital database (comprising prospectively collated data) was undertaken to identify patients who had undergone full thickness tracheal resection and reconstruction using a composite nasal septal graft; demographic, operative technique and survival outcome data were collated.


Three patients had a composite nasal septal graft performed for reconstruction of full thickness laryngotracheal defects following the excision of well-differentiated thyroid cancer. There were no cases of local recurrence after a minimum of 18 months' follow up.


This paper describes our surgical technique for reconstruction of these defects using a composite nasal septal graft. It also presents data on our three cases to date, in which the technique has been used safely. A discussion of the surgical management of locally invasive, well-differentiated thyroid cancer is provided.


Corresponding author

Address for correspondence: Dr Samuel Dowthwaite, Department of Otolaryngology – Head and Neck Surgery, Gold Coast Hospital, Nerang Street, Southport, QLD 4215, Australia E-mail:


Hide All
1Brennan, MD, Bergstralh, EJ, van Heerden, JA, McConahey, WM. Follicular thyroid cancer treated at the Mayo Clinic, 1946 through 1970: initial manifestations, pathologic findings, therapy, and outcome. Mayo Clin Proc 1991;66:1122
2Hay, ID, McConahey, WM, Goellner, JR. Managing patients with papillary thyroid carcinoma: insights gained from the Mayo Clinic's experience of treating 2,512 consecutive patients during 1940 through 2000. Trans Am Clin Climatol Assoc 2002;113:241–60
3Batsakis, JG. Laryngeal involvement by thyroid disease. Ann Otol Rhinol Laryngol 1987;96:718–19
4Honings, J, Stephen, AE, Marres, HA, Gaissert, HA. The management of thyroid carcinoma invading the larynx or trachea. Laryngoscope 2010;120:682–9
5Czaja, JM, McCaffrey, TV. The surgical management of laryngotracheal invasion by well-differentiated papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg 1997;123:484–90
6Lipton, RJ, McCaffrey, TV, van Heerden, JA. Surgical treatment of invasion of the upper aerodigestive tract by well-differentiated thyroid carcinoma. Am J Surg 1987;154:363–7
7Ark, N, Zemo, S, Nolen, D, Holsinger, FC, Weber, RS. Management of locally invasive well-differentiated thyroid cancer. Surg Oncol Clin N Am 2008;17:145–55
8Friedman, M. Surgical management of thyroid carcinoma with laryngotracheal invasion. Otolaryngol Clin North Am 1990;23:495507
9McCaffrey, JC. Aerodigestive tract invasion by well-differentiated thyroid carcinoma: diagnosis, management, prognosis, and biology. Laryngoscope 2006;116:111
10Sywak, M, Pasieka, JL, McFadden, S, Gelfand, G, Terrell, J, Dort, J. Functional results and quality of life after tracheal resection for locally invasive thyroid cancer. Am J Surg 2003;185:462–7
11Koike, E, Yamashita, H, Noguchi, S, Yamashita, H, Ohshima, A, Watanabe, S et al. Bronchoscopic diagnosis of thyroid cancer with laryngotracheal invasion. Arch Surg 2001;136:1185–9
12Friedman, M, Mayer, AD. Laryngotracheal reconstruction in adults with the sternocleidomastoid myoperiosteal flap. Ann Otol Rhinol Laryngol 1992;101:897908
13East, C, Grant, H, Jones, B. Tracheal reconstruction using a composite microvascular temporoparietal fascia flap and nasal septal graft. J Laryngol Otol 1992;106:741–3
14Drettner, B, Lindholm, CE. Experimental tracheal reconstruction with composite graft from nasal septum. Acta Otolaryngol 1970;70:401–7
15Zohar, Y, Shvilli, I, Laurian, N. Laryngeal reconstruction by composite nasoseptal graft after extended partial laryngectomy. Twelve-year follow-up. Arch Otolaryngol Head Neck Surg 1988;114:868–71
16Krizek, TJ, Kirchner, JA. Tracheal reconstruction with an autogenous mucochondrial graft. Plast Reconstr Surg 1972;50:123–30
17Duncavage, JA, Ossoff, RH, Toohill, RJ. Laryngotracheal reconstruction with composite nasal septal cartilage grafts. Ann Otol Rhinol Laryngol 1989;98:581–5
18Cansiz, H, Yener, M, Bozkurt, AK, Demir, A, Demirkaya, A, Sekercioglu, N. Surgical treatment of laryngeal tumors with subglottic extension and tracheal tumors with composite nasal septal cartilage graft: technique and outcome. Auris Nasus Larynx 2008;35:363–8
19Laurian, N, Zohar, Y, Turani, H. Histologic findings in a larynx reconstructed by a nasoseptal autograft after partial laryngectomy. Laryngoscope 1983;93:1481–2
20Zohar, Y, Hadar, H, Laurian, N. Computed tomography evaluation of the nasal septal reconstructed larynx. Head Neck Surg 1985;7:357–64
21Bozkurt, AK, Cansiz, H. Tracheal reconstruction with autogenous composite nasal septal graft. Ann Thorac Surg 2002;74:2200–1


Related content

Powered by UNSILO

Tracheal reconstruction using composite nasal septal graft in patients with invasive thyroid carcinoma

  • S Dowthwaite (a1), M Friel (a2) and S Coman (a2)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.