PMC9936615_01
Bronchoscopic image; the scope positioned just cranial to the vocal cords shows the presence of a polypoid lesion within the infraglottic airway.
fonc-13-1016232-g001.jpg
PMC9936615_01_fonc-13-1016232-g001.jpg
f1
Bronchoscopy showed a bulging mass 2 cm below the voice box, which obstructed 80% of the lumen ( Figure 1 ).
Preoperative enhanced CT scan showing a remodeled area of cervical with posterior wall erosion (red arrow).
fonc-13-1016232-g002.jpg
PMC9936615_01_fonc-13-1016232-g002.jpg
f2
CT value of the plain scan was about 64 HU, and that of the enhanced scan was about 85 HU in the venous phase. Cervical posterior tracheal nodules were observed, and their nature was determined through microscopic examination ( Figure 2 ).
Preoperative enhanced MR showing a remodeled area of cervical with posterior wall erosion (red arrow).
fonc-13-1016232-g003.jpg
PMC9936615_01_fonc-13-1016232-g003.jpg
f3
Enhanced MR in the neck revealed a nodular shadow in the cervical trachea of about 16 mm x 15 mm, and visible enhancement revealed long T1 and long T2 signals ( Figure 3 ).
Real-time video of the operation process. In the case presented in this study, the defect was repaired by suturing the two lateral edges of the fascial tissue flap with the end of second to fourth tracheal rings and soft tissue in opposite positions. (A) Lateral freeing of the left thyroid gland, protection of the superior and inferior parathyroid glands, and the recurrent laryngeal nerve to expose the tumor. (B) Complete resection of the tracheal membrane tumor. (C) Tracheal membrane defect. (D) Preparation of a double-tipped banded myofascial flap. (E) No damage to the thyroid gland and recurrent laryngeal nerve after repair. (F) Specimen presentation.
fonc-13-1016232-g004.jpg
PMC9936615_01_fonc-13-1016232-g004.jpg
f4
The defect was repaired by suturing the two lateral edges of the fascial tissue flap with the end of the second to fourth tracheal rings and soft tissue in opposite positions ( Figure 4 ).
Three months after treatment, reexamination of bronchoscope showed a smooth surface of reconstruction site, with no tracheostenosis.
fonc-13-1016232-g005.jpg
PMC9936615_01_fonc-13-1016232-g005.jpg
f5
Bronchoscopy examination on the ninth day after surgery showed a slight bulge 2-6 cm below the glottis, behind the second to fourth tracheal rings, with white moss attached ( Figure 5 ).
Hematoxylin and eosin staining revealed large cells with cytoplasmic granules.
fonc-13-1016232-g006.jpg
PMC9936615_01_fonc-13-1016232-g006.jpg
f6
The microscopic findings are presented in  Figure 6 .