case_images: PMC11736962_01
case_images: Axial section of CT neck/thorax; red arrow highlights invasion of mediastinal mass into posterior trachea (A). Level IV lymph node compressing the right internal jugular vein (B)
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case_images: PMC11736962_01_12957_2025_3653_Fig1_HTML.jpg
case_images: Fig1
case_images: Figure 1 demonstrates the pre-operative CT findings.
case_images: Post-operative CT scan on day 5 (axial section) demonstrates collections in the surgical bed (red arrow) (A). Fluid and gas locules within the retrosternal space (red arrow - panel B). Collection extending into the superior mediastinum (B)
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case_images: PMC11736962_01_12957_2025_3653_Fig2_HTML.jpg
case_images: Fig2
case_images: On the fifth postoperative day, he developed neck cellulitis, surgical emphysema and sepsis (Fig. 2).
case_images: Post-operative CT scan following AMT; A and B demonstrate the mediastinal tracheostomy, through the circular opening in the Pectoralis Major flap (red arrow). Sagittal sections (C and D) demonstrating tracheostomy tube entering distal trachea through the muscle flap. Axial section below level of the tracheostoma (panel E)
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case_images: PMC11736962_01_12957_2025_3653_Fig3_HTML.jpg
case_images: Fig3
case_images: The flap was dropped into the mediastinum, ensuring no tension on the tracheal stoma (Fig. 3).
case_images: Schematic illustration of the mediastinal tracheostomy stump sutured to pectoralis muscle flap and its relation to innominate vessels. A Innominate artery (B) Left innominate vein. C Right innominate vein (D) Pectoralis muscle flap (E) Tracheostomy stump
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case_images: PMC11736962_01_12957_2025_3653_Fig4_HTML.jpg
case_images: Fig4
case_images: The distal third of viable trachea was mobilized, ensuring preservation of blood supply and was transposed slightly inferior and lateral to the innominate artery (Fig. 4). Figure 4 shows a schematic drawing of tracheostomy secured to pectoralis muscle flap and its relations to innominate vessels.
case_images: Early post-operative appearances four weeks post discharge from hospital; AP view (A), left lateral view (B)
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case_images: Fig5
case_images: Figure 5 demonstrates the early post-operative appearances in the outpatient clinic four weeks following discharge.