A 64-year-old male patient attended the Oral and Maxillofacial Surgery Department of the Hospital Universitario Central de Asturias with squamous cell carcinoma affecting the lingual border, the lateral oropharyngeal wall, the tonsillar area and the left soft hemipalate. There were also large metastatic adenopathies in the vascular axes and in the submaxillary regions on both sides of the neck.
In a first surgical step, the tumour was resected, a classic left cervical radical resection and a reconstruction of the defect with a microvascularised anterolateral fasciocutaneous microfasciocutaneous thigh flap. Three weeks later, a classic right radical cervical resection was performed. Due to the magnitude of the surgery and in anticipation of possible postoperative complications, an elective rule tracheotomy was also performed in the first operation, using the Björk flap as a means of opening the trachea. The tracheostomy was maintained until several days after the second operation, with spontaneous closure of the tracheostoma occurring after decannulation of the patient and release of the tracheal flap attachment to the skin.

Subsequently, the patient received complementary radiotherapy treatment of the oral cavity, the oropharynx and cervical lymph node levels I to VI.
A control cervicothoracic CT scan, requested 4 months after surgery, revealed the existence of a small mass compatible with a neoplastic process in the right middle lobe of the lung, for which reason he was referred to the Pneumology Department. A bronchoscopy was then performed, in which a suture thread was observed in the lumen of the trachea, black in colour, about 2.5 cm long, inserted at one end into the anterior tracheal wall. An attempt was made to remove it, but when it was found to be firmly fixed, and to avoid possible tears in the tracheal wall, it was decided not to do so. Finally, the lung mass turned out to be inflammatory in nature and resolved spontaneously.

In relation to the tracheal suture thread, the only symptomatology reported by the patient was an occasional foreign body sensation, without causing cough or dyspnoea.