title: Excision of adenoid cystic carcinoma of the cervical trachea via an anterior castellated approach.
abstract: Adenoid cystic carcinoma of the cervical trachea is rare and its diagnosis and surgical management challenging. We report a case with an unusual presentation and discuss the diagnosis and management. The preferred surgical management is tracheal resection, however this is often not feasible and many alternative techniques have been used. Here an anterior castellated approach is described, a modification of that more commonly used for benign tracheal strictures. We found it gave excellent access to the posterior tracheal wall which we feel is superior to a straight vertical tracheal incision. It also facilitates a tracheal widening procedure if indicated, and safeguards the recurrent laryngeal nerves which are particularly vulnerable in the cervical part of the trachea.
authors.affiliation: Head and Neck Unit, Royal Marsden Hospital, London, UK.
authors.forename: B E
authors.initials: BE
authors.lastname: Hartley
authors.forename: J J
authors.initials: JJ
authors.lastname: Fagan
authors.forename: P H
authors.initials: PH
authors.lastname: Rhŷs-Evans
mesh_terms: D003528:Carcinoma, Adenoid Cystic / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000379:methods*; D014132:Trachea / Q000601:surgery*; D014134:Tracheal Neoplasms / Q000601:surgery*