«Espondilodiscitis cervical: Una complicación rara después de la inserción de prótesis fonatoria.»
Andrea Bolzoni, MD 1, Giorgio Peretti, MD 1, Cesare Piazza, MD 1, Davide Farina, MD 2, Piero Nicolai, MD 1 *
1Department of Otorhinolaryngology, University of Brescia, Spedali Civili, Piazza Spedali Civili 1, 25123 Brescia, Italy 2Institute of Radiology, University of Brescia, Brescia, Italy
email: Piero Nicolai (firstname.lastname@example.org)
Keywords cervical spondylodiscitis tracheoesophageal puncture phonatory prosthesis complication
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 neopharynx-esophagus 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.
© 2005 Wiley Periodicals, Inc. Head Neck 28: XXX-XXX, 2005.