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ARTICLE TYPE : CASE REPORT

Published on :   22 Oct 2026, Volume - 2
Journal Title :   WebLog Journal of Head and Neck Surgery | WebLog J Head Neck Surg | WJHNS
Source URL:   weblog icon https://weblogoa.com/articles/wjhns.2026.j2203
Permanent Identifier (DOI) :   doi icon https://doi.org/10.5281/zenodo.23613048

Novel Tracheal Reconstruction Using NEOVEIL® PGA Felt and Sternothyroid Flap

Mahmoud Sobhy Alam 1
Tarek Fetohi 1
Ahmed Gaber Hassanein 1 *
Arafat Mahmoud 2
Mohamed Abdallah Abozeid 2
1Maxillofacial and Head & Neck Surgery Unit, Department of General Surgery, Faculty of Medicine, Sohag University, Sohag, Egypt
2Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Sohag University, Sohag, Egypt

Abstract

Background: Tracheal wall defects pose substantial reconstructive difficulties in head and neck surgery, particularly when complicated by chronic inflammation, fibrosis, and retained foreign material. Although multiple repair techniques have been documented, the application of absorbable Polyglycolic Acid (PGA) sheets in tracheal reconstruction remains infrequently reported.

Case Presentation: We describe a 54-year-old male who developed a recurrent cervical mass with airway compromise four years following right hemithyroidectomy for follicular adenoma with Hürthle cell changes. Imaging revealed a large right paratracheal lesion with tracheal displacement. Fine-needle aspiration cytology demonstrated necrotizing granulomatous inflammation without malignancy. Intraoperative exploration identified a retained surgical sponge (gossypiboma) from the prior procedure, accompanied by purulent collection and dense fibrosis. After foreign body removal and debridement, a lateral tracheal defect involving two cartilage rings was observed. Reconstruction was performed via primary mucosal closure with interrupted absorbable sutures, reinforced with a pedicled sternothyroid muscle flap, and covered with a NEOVEIL® absorbable PGA felt sheet.

Results: The postoperative course was uncomplicated, with no evidence of air leak, subcutaneous emphysema, dysphonia, or respiratory distress. Follow-up bronchoscopy revealed satisfactory mucosal healing, preserved airway patency, and minimal granulation tissue. The patient remained asymptomatic throughout the one-month follow-up period.

Conclusion: Retained surgical sponges may rarely manifest as complex inflammatory neck masses with secondary tracheal erosion. The combined use of an absorbable PGA biomaterial scaffold and local muscle flap reinforcement appears to be a safe and effective approach for tracheal reconstruction in selected complex cases.

Keywords: Tracheal Reconstruction; Gossypiboma; Retained Foreign Body; Tracheal Erosion; Polyglycolic Acid Film; Thyroidectomy

Citation

Alam MS, Fetohi T, Hassanein AG, Mahmoud A, Abozeid MA. Novel Tracheal Reconstruction Using NEOVEIL® PGA Felt and Sternothyroid Flap. WebLog J Head Neck Surg. wjhns.2026.j2203. https://doi.org/10.5281/zenodo.23613048
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