Surgical Treatment of A Tracheal Necrosis due to Mediastinitis after Thyroid Resection

Tracheal necrosis is very rare after thyroid surgery. Only a dosen of patients had been reported in the literature and just one of them was treated with anastomosis. A 51-year old man underwent thyroid resection and had an uneventful postoperative course. After 6 days he returned hospital with swelling in the neck and high fever. Under general anesthesia the incision was opened and purulent section was drained. The trachea was necrotic below the cricoid for 3 cm. Wide surgical debridment was performed and the wound was closed with vaccum-assited closure (VAC) system. The bronchial tree was cleaned with daily bronchoscopy. After 4 cycles of VAC the wound explored again. The proximal and distal ends of the trachea was trimmed to remove the infected tissues and end-toend anastomosis was performed.