Delayed hypopharyngeal and esophageal perforation after anterior spinal fusion: primary repair reinforced by pedicled pectoralis major flap

Spine
Wolfgang PichlerWolfgang Grechenig

Abstract

This report documents a case of delayed hypopharyngeal and esophageal perforation after anterior spinal fusion and reviews relevant literature. Presentation of an alternative solution of primary repair and reinforcement of a delayed esophageal and hypopharyngeal perforation after anterior spinal fusion. Anterior plating is generally used for stabilization after cervical spine trauma. Esophageal and hypopharyngeal perforation is a rare but potentially life-threatening complication due to mediastinitis with consecutive septic shock and multiorgan failure. Our patient was operated on after cervical trauma caused by car accident. The neurologic condition did not improve in the postoperative period. About 4 months later, the patient had increasing dysphagia as well as episodes of odynophagia. Flexible esophagoscopy showed a perforation of a part of the plate from the hypopharynx down to the proximal esophagus. Primary repair reinforced by a pedicled pectoralis major flap was done without complications. Postoperative fluoroscopy as well as endoscopy showed no signs of perforation. Swallowing was possible without any further episodes of dysphagia or odynophagia. Neck movement was unconfined. Primary repair reinforced by pedicled pecto...Continue Reading

References

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Citations

May 8, 2009·HNO·D KleemannE Donauer
Oct 12, 2010·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Haijun TianDeyu Chen
Sep 23, 2009·Journal of Neurosurgery. Spine·Elias DakwarFernando L Vale
Jun 30, 2015·Neurologia Medico-chirurgica·Taku Sugawara
Sep 28, 2010·The Annals of Thoracic Surgery·Natasha RuethRafael Andrade
Apr 16, 2016·Journal of Neurosurgery. Spine·Sameer H HalaniFaiz U Ahmad
Jan 8, 2016·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Hisanori IkumaYoshiki Yokoyama
Nov 4, 2016·British Journal of Neurosurgery·Lei XiaMassimiliano Visocchi
Sep 13, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ottorino PerroneSandro Mattioli
Nov 26, 2015·Auris, Nasus, Larynx·Mustafa AslıerAhmet Omer Ikiz
Feb 5, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Ferhat HarmanAskin Esen Hasturk
Feb 6, 2017·Journal of Neurosurgery. Spine·Syed A QuadriJaved Siddiqi
Jun 18, 2020·World Journal of Clinical Cases·Qi-Hang SuSong Guo
Dec 23, 2014·Ear, Nose, & Throat Journal·Christopher Chase Surek, Douglas A Girod
Aug 30, 2018·Digestive Diseases and Sciences·Nathan S Ramrakhiani, George Triadafilopoulos
Apr 22, 2020·World Neurosurgery·Michael GhirelliLivio Presutti

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