Novel Hyoid Reconstruction and Tracheal Onlay Grafting in a Child with Teratoma and Absence of Hyoid.

Herein is presented a case of a 3-year-old who was the product of a pregnancy complicated by fetal congenital cervical teratoma. The teratoma was resected day-of-life 6, and he underwent tracheotomy. Radiologic review of his cartilaginous cervical anatomy in utero, pre- and post-tumor excision indicated congenital absence of the hyoid. An initial double-staged laryngotracheal reconstruction improved the subglottic and tracheal airway, but the supraglottic and pharyngeal airway remained collapsed. Using a cadaveric cartilage, a hyoid was fashioned. After the pharynx and straps muscles were sewn to the hyoid construct, the supraglottic and supra-laryngeal airway improved. Subsequent laryngotracheal reconstruction, which included tracheal onlay grafts of cadaveric cartilage, achieved decannulation. Laryngoscope, 134:5207-5209, 2024.