title: Surgical treatment of laryngeal tumors with subglottic extension and tracheal tumors with composite nasal septal cartilage graft: technique and outcome.
abstract: OBJECTIVE
  Composite nasal septal cartilage grafts (CNSCG) are effective grafting materials in laryngeal and tracheal reconstruction following tumor resection.
  
  
  METHODS
  Between 1985 and 2005, we used CNSCG for the reconstruction of defects following resection of laryngeal tumors with subglottic extension (20 cases), subglottic mesenchymal tumors (2 cases), invasive thyroid carcinoma (4 cases), tracheal tumors (3 cases) and esophagus carcinoma with tracheal invasion (1 case) in total of 30 patients.
  
  
  RESULTS
  The patients with subglottic tumors were decanulated within 5-7 days except one case. We achieved satisfactory voice and swallowing without any sign of recurrence. Overall complications consisted of subglottic stenosis in one case, and unilateral paralysis of recurrent laryngeal nerve in two cases. One patient with subglottic laryngeal carcinoma died due to neck and distant metastases 4 years after the operation. All patients are well with a mean follow-up period 9 years. Three patients with tracheal tumors underwent lateral resection and reconstructed with CNSCG. Satisfactory healing of the grafts was seen in all cases without local recurrence or complication with a mean follow-up period of 62 months. One of the patients had distant metastases 3 years after the operation. The patient with esophagus carcinoma and tracheal invasion was treated by total esophagectomy, gastric pull-up, tracheal resection and CNSCG reconstruction. He died at postoperative 5th day due to mediastinitis as a complication of gastric pull-up.
  
  
  CONCLUSIONS
  Free composite cartilage graft is a reliable material in the reconstruction of defects after surgery of laryngeal tumors with subglottic extension, invasive thyroid and esophagus tumors and well-selected tracheal tumors.
authors.affiliation: Istanbul University Cerrahpaşa Medical Faculty, Department of Otolaryngology, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Cansiz
authors.forename: Murat
authors.initials: M
authors.lastname: Yener
authors.forename: A Kursat
authors.initials: AK
authors.lastname: Bozkurt
authors.forename: Adalet
authors.initials: A
authors.lastname: Demir
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demirkaya
authors.forename: Nihat
authors.initials: N
authors.lastname: Sekercioglu
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D002356:Cartilage / Q000637:transplantation*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008637:Mesenchymoma / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010212:Papilloma / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery; D014134:Tracheal Neoplasms / Q000473:pathology / Q000601:surgery*