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ISSN 2992-8559 (Electronic)
ISSN 1405-0625 (Print)

2018, Number 2

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Cir Plast 2018; 28 (2)

Sternocleidomastoid muscle flap for tracheocutaneous fistula treatment: a case report

Espino-Gaucín I, Vargas-Flores E, García-Sánchez M

Language: Spanish
References: 20
Page: 66-69
PDF size: 328.61 Kb.


ABSTRACT

Tracheocutaneous fistula is an uncommon complication of total thyroidectomy, and only isolated reports can be found in world literature, which is why a consensus for surgical repair is not available. There are reports that recommend reinforcement with close anatomical structures such as the sternocleidomastoid muscle. The case of a 64-year-old female with a past medical history of 13 years of hypothyroidism and papillary thyroid carcinoma treated with total thyroidectomy in 2013 with an adequate recovery is shown. Six months after her surgery, she presented a gradual increase in the volume in cervical levels III and IV with transudation of serous material through an anterior cervical skin orifice. A fistulography showed opacification of a 20 mm tract into the airway. A fistulectomy was performed with primary closure and reinforcement with the sternocleidomastoid muscle. The final histopathologic diagnosis revealed a tracheocutaneous fistula with focal granulomatous chronic inflammation. We concluded that definitive surgical treatment of a tracheocutaneous fistula has not been clearly defined. Muscle flap with sternocleidomastoid muscle is a viable option for the treatment of tracheocutaneous fistula and it is a valuable resource in reconstructive surgery. One of the most important factors in the success of this procedure is the proper identification of the fistula tract and knowledge of the vascular anatomy of the muscle flap.


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