Endoscope-assisted conservative resection and reconstruction in
recurrent subglottic carcinoma
Shawn T. Joseph MD
Jose Tharayil MBBS, MS, FRCS
Mihir Mohan T. MBBS, DNB
Naveen B.S. MDS
Department of Head and Neck Surgical
Oncology, VPS Lakeshore Hospital,
Cochin, Kerala, India
Department of Plastic Surgery, VPS
Lakeshore Hospital, Cochin, Kerala, India
Shawn T. Joseph, Department of Head
and Neck Surgical Oncology, VPS
Lakeshore hospital, NH-47 Bypass,
Maradu, Nettoor P.O, Kochi, Kerala,
Section Editor: Peter Andersen, MD
Background: Very few cases of conservative laryngectomy in recurrent carcinoma
of subglottis postradiotherapy have been reported. Technical aspects of conservative
resection and reconstruction in subglottic carcinoma have not been well described.
Methods: Herein, we present a case of recurrent carcinoma of subglottis for which
conservative resection with adequate margins was done with endoscope assistance
and defect reconstructed by buccal mucosa, conchal cartilage, and temporoparietal
free flap. The technique of resection, reconstruction, complications, postoperative out-
come, and our suggestions are described.
Results: The lesion could be removed with wide margins. Reconstruction could pre-
serve the voice, and deglutition was unaffected. There was no donor site-related
complication. Complications were a result of the choice of the stent, which included
infection and difficulty in removal.
Conclusion: Selected cases of recurrent carcinoma of the subglottis can be managed
by conservative resection with adequate margins and appropriate reconstruction with
good functional outcomes.
conservative laryngectomy, postradiation larynx, postradiation subglottis, subglottic carcinoma, temporopar-
Carcinoma of the subglottis is relatively rare compared with
other laryngeal subsites.
Recurrence in a case of carcinoma
subglottis, which was previously treated by radiotherapy, is
usually managed by total laryngectomy.
The reasons for
this are the difficulty to leave a functional larynx after onco-
logical resection and difficult visualization for surgical
access. A detailed literature review on the subject shows that
conservative open surgical resection and/or reconstruction of
recurrent carcinoma of the subglottis has not been explored
We present the case of a 49-year-old man who came to us
with the complaint of hoarseness of his voice. He had a
known case of carcinoma of the subglottis, for which post
laser excision was done on August 14, 2013, followed by
radiotherapy at a dose of 60 Gy/30 fractions, which was
completed on October 25, 2013. There was no history of any
addictions or systemic diseases. He was apparently normal
for 1 year when he developed hoarseness of his voice, for
which he underwent a CT scan at a local center, which
This article was published online on 5 February 2018. An error was
subsequently identified. This notice is included in the online and print
versions to indicate that both have been corrected 16 February 2018.
2018 Wiley Periodicals, Inc. wileyonlinelibrary.com/journal/hed Head & Neck. 2018;40:E36–E39.
Received: 11 May 2017
Revised: 9 October 2017
Accepted: 20 December 2017