Background. Tracheoesophageal puncture has excellent voice rehabilitation after total laryngectomy. However, despite its easy insertion and use, severe complications have been reported. Methods. We report a case of cervical spondylodiscitis, occurring in a 67-year-old woman submitted to phonatory prosthesis insertion. After 1 month, she complained of severe cervicalgia associated with fever. Spondylodiscitis involving C6, C7, and the intervening vertebral disk with medullary compression was detected by means of imaging studies. Results. A right cervicotomy with drainage of necrotic tissue was performed, and a deepithelialized fasciocutaneous deltopectoral flap was interposed between the neopharynxesophagus and the prevertebral fascia to protect the neurovascular axis MR performed 1 month later showed a complete resolution of the infectious process. Conclusions. Severe neck pain after tracheoesophageal puncture should alert the physician about the possibility of a cervical spondylodiscitis. MR is the most useful imaging technique for preoperative and postoperative evaluation. When neurologic symptoms are detected, surgical exploration of the neck is mandatory.

Cervical spondylodiscitis: A rare complication after phonatory prosthesis insertion / A. Bolzoni, G. Peretfi, C. Piazza, D. Farina, P. Nicolai. - In: HEAD & NECK. - ISSN 1043-3074. - 28:1(2006), pp. 89-93.

Cervical spondylodiscitis: A rare complication after phonatory prosthesis insertion

Piazza, Cesare;
2006

Abstract

Background. Tracheoesophageal puncture has excellent voice rehabilitation after total laryngectomy. However, despite its easy insertion and use, severe complications have been reported. Methods. We report a case of cervical spondylodiscitis, occurring in a 67-year-old woman submitted to phonatory prosthesis insertion. After 1 month, she complained of severe cervicalgia associated with fever. Spondylodiscitis involving C6, C7, and the intervening vertebral disk with medullary compression was detected by means of imaging studies. Results. A right cervicotomy with drainage of necrotic tissue was performed, and a deepithelialized fasciocutaneous deltopectoral flap was interposed between the neopharynxesophagus and the prevertebral fascia to protect the neurovascular axis MR performed 1 month later showed a complete resolution of the infectious process. Conclusions. Severe neck pain after tracheoesophageal puncture should alert the physician about the possibility of a cervical spondylodiscitis. MR is the most useful imaging technique for preoperative and postoperative evaluation. When neurologic symptoms are detected, surgical exploration of the neck is mandatory.
cervical spondylodiscitis; tracheoesophageal puncture; phonatory prosthesis; complication
Settore MED/31 - Otorinolaringoiatria
Settore MED/36 - Diagnostica per Immagini e Radioterapia
HEAD & NECK
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/624272
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