Stair-step tracheal repair: Surgical technique

John R. Sims, Quinn F. O'Malley, Sarah L. Spaulding, Lauren E. Yue, Mark L. Urken

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Typical surgical treatment for invasive thyroid carcinoma at the level of the cricoid substantially reduces surrounding cartilaginous support and risks damage to the recurrent laryngeal nerve (RLN). We present a novel tracheal reconstructive technique that minimizes this injury risk. A 72-year-old man with recurrent invasive thyroid carcinoma underwent cricotracheal resection and reconstruction using a stair-step approach. Diseased cartilage was removed by a left hemitracheal and hemicricoid resection. A portion of normal trachea was also resected on the contralateral right side, removing the third and fourth hemitracheal rings, to close the defect with a sliding tracheoplasty and avoid dissection near the right cricothyroid joint on the side of the functioning RLN. The trachea was elevated superiorly and reanastomosed to the cut margin of the cricoid. This novel stair-step approach to tracheal reconstruction offers reduced risk of injury to the contralateral RLN while still establishing a patent airway.

Original languageEnglish
Pages (from-to)2741-2744
Number of pages4
JournalHead and Neck
Issue number9
StatePublished - 1 Sep 2020
Externally publishedYes


  • aggressive thyroid cancer
  • papillary thyroid cancer
  • stair-step procedure
  • tracheal resection
  • tracheoesophageal invasion


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