Vol.99 No.7 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 7 July 2006
Laryngeal Carcinosarcoma Recurring with
Innominate Artery Fistula: A Case Report
Daizo Taguchi, Hideyuki Kataoka, Katsuyuki Kawamoto, Kensaku Hasegawa,
Eiji Takeuchi, Bin Nakayama and Hiroya Kitano
(Tottori University)
Takema Sakoda
(Japanese Red Cross Society Wakayama Medical Center)
Innominate artery fistulas require a surgical procedure, although the prognosis is usually very poor because of complications such as re-bleeding and infection. A 50-year-old man presented with laryngeal carcinosarcoma (T1a, N0, M0). Partial laryngectomy was performed but there was a recurrence; therefore, total laryngectomy, total thyroidectomy, right radical neck dissection, left functional neck dissection, skin-combined resection and D-P flap were performed. On postoperative day 6, after intense coughing, copious hemorrhage from the tracheostoma was demonstrated. Immediately, bleeding was arrested by pressing the tracheostoma. Fistula of the innominate artery was then repaired using left great saphenous vein, but recurrent perforation of the innominate artery developed. Therefore, innominate artery transection and omentopexy were performed. These results demonstrate that in cases of trachea-innominate artery fistula, innominate artery transection should be performed first.
Key words:
laryngeal carcinosarcoma, innominate artery fistula, total laryngectomy, trachea-innominate artery fistula, innominate artery transection