A 64-year-old male patient came to the Department of Oral and Maxillofacial Surgery of the Central University Hospital of Asturias for presenting a squamous cell carcinoma that affected the lingual border, the lateral wall or the lateral face.
He also had large metastatic lymph nodes in the vascular axes and submaxillary regions of both sides of the neck.
In the first surgical time, resection of the tumor, classic left radical neck dissection and reconstruction of the defect with an anterolateral fasciocutaneous microvascular flap of the thigh were performed.
Three weeks later a classic radical neck dissection was performed.
Given the magnitude of the surgery and in anticipation of possible postoperative complications, in the first intervention an elective scheduled thoracotomy was performed, using the Björk flap as a way to open the trachea.
Pathotomy was maintained until several days after the second intervention, resulting in spontaneous closure of the stoma after decannulation and release of the tracheal flap to the skin.
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Subsequently, the patient received radiotherapy over the oral cavity, orpharyngeal and cervical lymph node levels I to VI.
A control cervicothoracic CT, requested 4 months after surgery, showed the existence of a small mass compatible with a neo-neoplastic process in the right middle lung lobe, which was the reason for the referral to the Pneumology Department.
Bronchoscopy was then performed, in which a black suture line of 2.5 cm long was observed in the lumen of the trachea inserted through one of its anterior tracheal wall.
An attempt was made to remove, but upon checking that it was firmly fixed, and in order to avoid possible tears in the tracheal wall, it was decided not to do so.
Finally, the pulmonary mass was inflammatory in nature and resolved spontaneously.
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In relation to the tracheal suture thread, the only symptoms reported by the patient were occasionally foreign body sensation without causing cough or dyspnea.
