Pharyngeal perforation after anterior cervical spine surgery treated by transoral endoscopic surgery

Rama-López, Julio; Tomás-Fernandez, Meritxell; García-Garza, César; Martínez-Madrigal, Milton

doi:10.1002/hed.25030

Cited by 4 publications

(5 citation statements)

References 15 publications

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“…Hyoid bone is at the third cervical vertebra (C3) level at rest. In the literature, all of the patients who has pharyngeal perforation after ACFS, the initial operation involves the level of C3 [18][19][20]. In the present case, the fixation devices of both patients caused pharyngeal perforation at the C3 level.…”

Section: Discussionmentioning

confidence: 57%

“…to swallowing, painful swallowing or sore throat, weight loss, foreign body sensation in the throat and coughing out to the fixation device [18][19][20]. If the perforation is not diagnosed in the early period and the treatment is delayed, catastrophic consequences may occur which may cause death such as septicemia, mediastinitis, pneumonia and meningitis [10].…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, the vast majority of cases [18][19][20] were treated by removal of the remaining and/or migrated fixation device and secondary wound healing. Rama-Lopez, et al [19] reported a case of ulcerated pharyngeal perforation and treated with surgical debridement.…”

Section: Discussionmentioning

confidence: 99%

“…Our Case 1 was re-operated 12 weeks after the second surgery due to insufficient mucosal healing, despite the infectious status did not occur. Although many cases [18][19][20] are treated with broad-spectrum antibiotics and secondary wound healing at early stages some infected perforations require surgical drainage, mucosal or muscle flap, and revision surgeries [3]. Phommachanh, et al [4] reported five patients with pharyngoesophageal perforation.…”

Section: Discussionmentioning

confidence: 99%

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Pharyngeal Perforation after Anterior Cervical Fusion Surgery

Busra¹,

Çeltikçi²,

Aydíl³

et al. 2019

Neurosurg Cases Rev

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Study design: A case report to emphasize the treatment of two different pharyngeal perforation cases, one of which occurs in early and one in the late post-operative period.Objective: We aimed to remind the risk of pharyngeal perforation which is a rare but life-threatening complication in anterior cervical fusion surgery.Summary and background data: Pharyngeal perforation is a serious complication of anterior cervical fusion surgery. If it is not diagnosed in the early period and the treatment is delayed, catastrophic consequences may occur which may cause death such as septicemia, mediastinitis, pneumonia and meningitis. Methods and results:We shared the presentation of our two cases. In the first case, pharyngeal perforation and spontaneous extrusion of the C2-C3 fixation device occurred after eight years from surgery. The fixation device removed and the pharyngeal wall repaired surgically. In the second case, one of the upper screws perforated the posterior pharyngeal wall in the early post-operative period and migrated to the right bronchus. The fixation device excision was achieved with rigid bronchoscopy, and the pharyngeal perforation was treated symptomatically. Conclusions:The patients who underwent anterior cervical fusion surgery that contains the C3 level are at risk of pharyngeal perforation. If the fixation device migrated to the thoracic cavity, it should be removed by interventional and/or surgical methods for the prevention of infection. The treatment of pharyngeal perforation after anterior cervical fusion surgery should be planned by multidisciplinary team that involves spine surgeons as well as otolaryngologists.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Pharyngeal Perforation after Anterior Cervical Fusion Surgery

Busra¹,

Çeltikçi²,

Aydíl³

et al. 2019

Neurosurg Cases Rev

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“…In addition, the algorithm based on the positive and lateral position matching in this study was set as PLP-3DR. [13] and GP algorithm [14] were introduced to compare with the PLP-3DR algorithm proposed in this paper. e accuracy, sensitivity, and specificity were selected as the evaluation indicators of algorithm performance, which were expressed as follows:…”

Section: Ree-dimensional Reconstruction Algorithm Based On the Positive And Lateral Position Matchingmentioning

confidence: 99%

Intelligent Three-Dimensional Reconstruction Algorithm-Based X-Ray Film for Analysis of the Changes in Sagittal Parameters and Curative Effect of Anterior Cervical Surgery

Liu

Zhang

Wang

et al. 2021

Scientific Programming

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In this paper, the change characteristics of sagittal parameters of the patient’s body before and after anterior cervical surgery and rehabilitation effect were analyzed. The rotation transformation and perspective projection transformation were applied to construct a positive and lateral position (PLP) matching-based three-dimensional reconstruction (PLP-3DR) algorithm, which was compared with the marching cubes (MC) algorithm and gravity point (GP) algorithm. PLP-3DR was adopted in X-ray image diagnosis of 124 cervical spondylosis patients. Results showed that sensitivity, specificity, and accuracy of PLP-3DR were markedly higher than those of MC and GP ( P < 0.05 ). The postoperative C2-7 Cobbs’s angle (C2-7Cobb) (11.27 ± 8.41°) was smaller than that before the surgery (15.03 ± 7.39°) ( P < 0.05 ), while the postoperative cervical sagittal vertical axis (cSVA) (21.33 ± 10.38 mm) and Japanese Orthopaedic Association (JOA) scores (16.95 ± 6.07 points) were greater than those before the surgery (14.66 ± 9.68 mm and 11.39 ± 4.28 points) ( P < 0.05 ). Besides, the improvement rate of patients from the cSVA >25 mm group (68.31%) was greater than the rate of the cSVA <15 mm group (45.88%) and the cSVA within 15–25 mm group (47.29%) ( P < 0.05 ). In conclusion, PLP-3DR could effectively improve the diagnostic effect of spine X-ray film images, with high sensitivity and specificity. Anterior cervical surgery had a good curative effect for patients with cervical spondylosis and was closely related to cervical parameters (cSVA, T1 slope, and C2-7Cobb). In addition, patients with cSVA>25 mm could have the best postoperative rehabilitation effect.

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Transoral Endoscopic Approach to Repair Early Pharyngeal Perforations After Anterior Cervical Spine Surgery without Failure of Instrumentation: Our Experience and Review of Literature

et al. 2020

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Pharyngeal perforation after anterior cervical spine surgery treated by transoral endoscopic surgery

Abstract: We consider the transoral endoscopic approach a feasible low comorbidity technique to treat anterior cervical plate mobilization with pharyngeal and pharyngoesophageal perforations.

Cited by 4 publications

References 15 publications

Pharyngeal Perforation after Anterior Cervical Fusion Surgery

Pharyngeal Perforation after Anterior Cervical Fusion Surgery

Intelligent Three-Dimensional Reconstruction Algorithm-Based X-Ray Film for Analysis of the Changes in Sagittal Parameters and Curative Effect of Anterior Cervical Surgery

Transoral Endoscopic Approach to Repair Early Pharyngeal Perforations After Anterior Cervical Spine Surgery without Failure of Instrumentation: Our Experience and Review of Literature

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