Table 2.
Open airway surgery category
| Patient number, sex, age (years) | Referral | Pre-operative diagnosis | Pre-operative endoscopy | Surgery | Follow-up status |
|---|---|---|---|---|---|
| 1, female, 3.5 | International | January 2019: alkaline battery ingestion. July 2019 (prior to referral): tracheoesophageal fistula closure with post-operative bilateral vocal folds palsy. Required endoscopic dilatation every 2 weeks for severe tracheal stenosis | Bilateral vocal folds palsy. Tracheal stenosis (70% obstruction, 4 rings, localised inflammation) | Double-stage tracheal resection and anastomosis (6 rings excised) |
Decannulated and had an optimal age-appropriate airway. Normal oral solid and liquid feeds |
| 2, male, 3 | Extra-cantonal | 23 weeks premature. January 2019: tracheostomy for severe posterior glottic stenosis. 11 February 2020: partial laryngofissure, posterior costal cartilage graft, laryngotracheal mold |
Laryngotracheal mold in optimal position | Surgical closure of tracheostomy | Optimal airway. Occasional mild aspiration |
| 3, female, 78 | Cantonal | Poorly differentiated (90% follicular) thyroid cancer (cT4a cN1b) right vocal fold hypomobility | Infiltration of 2 tracheal rings. Trans-oesophageal ultrasound: muscles infiltrated, mucosa free |
Total thyroidectomy, selective neck dissection, single stage tracheal resection and anastomosis (3 rings), pectoralis major myofascial flap |
Right vocal fold palsy, optimal airway, no aspiration, mild hoarseness, adjuvant chemo-radiotherapy |
| 4, male, 75 (Figure 1a–c) | Cantonal | Papillary thyroid cancer cT4a cNo, bilateral vocal folds mobile | Infiltration of 3 tracheal rings. Transoesophageal ultrasound: oesophagus muscles infiltrated, mucosa spared |
Total thyroidectomy, selective neck dissection, single stage tracheal resection and anastomosis (4 rings), pectoralis major myofascial flap | Bilateral vocal folds mobile, optimal airway, post-operative radioiodine I-131 |
| 5, female, 31 (Figure 1d–g) | International | 2015: astrocytoma excision. January 2020: pneumonia, air ambulance transfer to our institution. February, March 2020: 2 temporising dilatations |
Tracheal stenosis (70% obstruction) | Single stage tracheal resection and anastomosis (4 rings) | Optimal airway, bilateral vocal folds mobile |
| 6, male, 33 | International | 2018: motor vehicle accident, paraplegia. Tracheostomy for severe posterior glottic stenosis. February 2020: laryngofissure, posterior costal cartilage graft, laryngotracheal mold | Laryngotracheal mold in good position | Surgical closure of tracheostomy | Optimal airway. Feeds: normal without aspiration |
| 7, female, 66 (Figure 1h and i) | Extra-cantonal | 2008: motor vehicle accident, tracheostomy, paraplegia. 2008: decannulated. 2016: continuous positive airway pressure (24/7). February 2020: acute exacerbation | Bilateral vocal folds mobile. Tracheal stenosis with severe A-frame deformity (90% obstruction, 3 rings) | Single stage tracheal resection and anastomosis (4 rings) | Optimal airway, bilateral vocal folds mobile |