[Atypical partial tracheolaryngectomy associated with circular pharyngectomy followed by flap reconstruction for dedifferentiated papillary carcinoma of the thyroid gland].

The management of the extensive malignancy of the hypopharynx generally combines with total laryngectomy. The authors report a case of scanty differentiated papillary thyroid carcinoma, extended to the hypopharynx, with partial involvement of thyroid, cricoid and first tracheal ring cartilage and unilateral vocal fold palsy treated with an "atypical" partial tracheo-laringectomy combined with total circular pharyngectomy. The defect has been replaced with an antero lateral tight free flap suitably modeled to restore the pharyngeal and laryngeal lumen. A modified Montgomery T- tube has been inserted to avoid larynges-tracheal stenosis. This unusual technique allowed to restore a stable airway and satisfying deglutition and an adequate voice. With this case presentation the authors want to subline that when the tumor type is less aggressive than squamous cell carcinoma, it is possible to perform a partial larynx preservation also in the case of circular pharyngectomy. Obviously the residual laryngeal skeleton have to be sufficient to restore laryngeal lumen.