Retropharyngeal cerebrospinal fluid collection as a cause of postoperative dysphagia after anterior cervical discectomy

Spennato, Pietro; Rapanà, Armando; Sannino, Ettore; Iaccarino, Corrado; Tedeschi, Enrico; Massarelli, Ilario; Bellotti, Alfredo; Schönauer, Massimo

doi:10.1016/j.surneu.2006.07.019

Cited by 21 publications

(9 citation statements)

References 18 publications

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“…Dysphagia after ACDF is related to pharyngeal contraction disturbance near the surgical site, and to deficient laryngeal closure, laryngeal penetration, and/or post-swallowing aspiration. Anterior dislodging of the bone graft, retropharyngeal abscess, esophageal hematoma, and respiratory disturbance may require urgent treatment 3,10,17 while nerve injury and/or soft-tissue damage may not need to be addressed surgically and may improve spontaneously.…”

Section: Discussionmentioning

confidence: 99%

“…Various degrees of postprocedural dysphagia have been reported. 2,5,17 According to Frempong-Boadu et al 5 who used video laryngoendoscopy, dysphagia often occurs in the 1st week after ACDF, although most of their patients remained asymptomatic. Severe dysphagia, defined on the Bazaz dysphagia score as difficulty swallowing most food, was observed in 5.6%-7.0% of patients 1 month after ACDF; thereafter, this rate decreased to 0.5%-1.3%.…”

Section: Discussionmentioning

confidence: 99%

“…matoma, and to covert complications such as neurological and/or soft-tissue injuries. 10,17 While some of these complications must be addressed immediately, others improve spontaneously. Surgical site infection and/or pharyngoesophageal perforation should be considered in patients who experience severe swallowing disturbance and a local and/or general inflammatory response reflected by widening of the prevertebral space, hyperthermia, and increases in the white blood cell (WBC) count and C-reactive protein (CRP) level.…”

mentioning

confidence: 99%

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Noninfectious prevertebral soft-tissue inflammation and hematoma eliciting swelling after anterior cervical discectomy and fusion

Yagi

Nakagawa²,

Okazaki³

et al. 2017

SPI

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OBJECTIVE Anterior cervical discectomy and fusion (ACDF) procedures are performed to treat patients with cervical myelopathy or radiculopathy. Dysphagia is a post-ACDF complication. When it coincides with prevertebral space enlargement and inflammation, surgical site infection and pharyngoesophageal perforation must be considered. The association between dysphagia and prevertebral inflammation has not been reported. The authors investigated factors eliciting severe dysphagia and its relationship with prevertebral inflammation in patients who had undergone ACDF. MATERIALS The clinical data of 299 patients who underwent 307 ACDF procedures for cervical radiculopathy or myelopathy at Kushiro Kojinkai Memorial Hospital and Kushiro Neurosurgical Hospital between December 2007 and August 2014 were reviewed. RESULTS After 7 ACDF procedures (2.3%), 7 patients suffered severe prolonged and/or delayed dysphagia and odynophagia that prevented ingestion. In all 7 patients the prevertebral space was enlarged. In 5 (1.6%) the symptom was thought to be associated with prevertebral soft-tissue edema; in all 5 an inflammatory response, hyperthermia, and an increase in the white blood cell count and in C-reactive protein level was observed. After 2 procedures (0.7%), we noted prevertebral hematoma without an inflammatory response. None of the patients who had undergone 307 ACDF procedures manifested pharyngoesophageal perforation or surgical site infection. CONCLUSIONS Severe dysphagia and odynophagia are post-ACDF complications. In most instances they are attributable to prevertebral soft-tissue edema accompanied by inflammatory responses such as fever and an increase in the white blood cell count and in C-reactive protein. In other cases these anomalies are elicited by hematoma not associated with inflammation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Noninfectious prevertebral soft-tissue inflammation and hematoma eliciting swelling after anterior cervical discectomy and fusion

Yagi

Nakagawa²,

Okazaki³

et al. 2017

SPI

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“…18 , 20-26 These reports are summarized in Table 2 . 20 The various repair strategies were successful but it is not clear why initial repair failed in the cases that underwent reoperation. Management of the dural lacerations and CSF leaks varied but all case reports indicated that repair was attempted during the index procedure.…”

Section: Literature Reviewmentioning

confidence: 99%

Cerebrospinal Fluid Leaks and Their Management After Anterior Cervical Discectomy and Fusion

Syre

Bohman

Baltuch

et al. 2014

Spine

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“…[1] Here, we have highlighted the airway management in such patient with pre-existing multiple airway problems and discussed the role of different airway management techniques.…”

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Airway management in patient with retropharyngeal cerebrospinal fluid collection with pre-existing multiple airway problems

Chowdhury

Govender

2013

Saudi J Anaesth

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Retropharyngeal cerebrospinal fluid collection as a cause of postoperative dysphagia after anterior cervical discectomy

Cited by 21 publications

References 18 publications

Noninfectious prevertebral soft-tissue inflammation and hematoma eliciting swelling after anterior cervical discectomy and fusion

Noninfectious prevertebral soft-tissue inflammation and hematoma eliciting swelling after anterior cervical discectomy and fusion

Cerebrospinal Fluid Leaks and Their Management After Anterior Cervical Discectomy and Fusion

Airway management in patient with retropharyngeal cerebrospinal fluid collection with pre-existing multiple airway problems

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