Sternocleidomastoid flap for repair of pharyngocutaneous fistula following anterior cervical spine surgery

Al-Mourgi, Majed

doi:10.4103/2278-0521.171428

Cited by 3 publications

(4 citation statements)

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“…There are anecdotal case reports in literature about the management of pharyngocutaneous fistula with no major series of more than five patients. [ 12 13 ]…”

Section: Discussionmentioning

confidence: 99%

“…There are anecdotal case reports in literature about the management of pharyngocutaneous fistula with no major series of more than five patients. [12,13] The presence of plate locking screw in the cricopharynx highlights the necessity of robust locking mechanism for screws in plate with quality control during manufacturing process. The patient also showed features of Horner's syndrome due to damage to the sympathetic chain during index surgery which was managed in consultation with an ophthalmologist.…”

Section: Discussionmentioning

confidence: 99%

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Pharyngocutaneous fistula and horner's syndrome following loosening of locking screw of anterior cervical plating: A rare case report and management

Jogani¹,

Rathod²,

Marathe³

et al. 2021

Asian J Neurosurg

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We hereby present a rare case of pharyngocutaneous fistula associated with locking screw loosening causing internal cricopharynx perforation and Horner's syndrome following anterior cervical plating. A 27-year-old male patient had undergone anterior cervical plating at C5–C7 level due to gunshot injury to the neck, and 1 month postsurgery, he developed fistula in the neck showing discharge of consumed food contents. He presented to us 1 year postsurgery with the discharging fistula, left upper-limb weakness, and Horner's syndrome that developed after surgery. The previously unexplored right side was used to remove implant, and owing to solid union at corpectomy, no additional fixation was performed. Intraoperatively, pharyngeal wall dehiscence was observed. Attempt of removal of impinged screw was abandoned since it migrated into the esophagus. Serial abdomen radiographs revealed successive passage of screw through the gastrointestinal (GI) tract until it could not be visualized. As the patient showed reduced discharge, a GI surgeon gave a conservative trial with nasogastric intubation. Currently, fistula is showing minimal discharge with no food. Having knowledge of this possible rare outcome and awareness of various multidisciplinary approaches for management makes practicing spine surgeon equipped to handle such undesirable complications.

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“…There are anecdotal case reports in literature about the management of pharyngocutaneous fistula with no major series of more than five patients. [ 12 13 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pharyngocutaneous fistula and horner's syndrome following loosening of locking screw of anterior cervical plating: A rare case report and management

Jogani¹,

Rathod²,

Marathe³

et al. 2021

Asian J Neurosurg

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“…After exposing the entire medial and lateral surface of the SCM, with preservation of spinal accessory nerves an inferiorly pedicled flap is interposed between the esophagus and the spine. 19 This is followed by suturing the distal end of the flap to the prevertebral tissue on the opposite side to hold the flap in place during the healing process. -Wound drainage (controlled esophagocutaneous fistula via T-tube placement).…”

Section: Treatmentmentioning

confidence: 99%

Esophageal Fistula following Anterior Cervical Discectomy and Fusion in Traumatic Cervical Injury Cases: A Review

Meena

Doddamani

Sawarkar

et al. 2020

Indian Journal of Neurotrauma

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Background Esophageal fistula is a very rare complication associated with anterior approaches to the cervical spine. Timely diagnosis and early intervention are associated with favorable outcomes. There is a dilemma in the literature for its optimal management. In this review article, we will discuss the management dilemmas in patients with esophageal perforation along with an illustrative case. Material and Methods A 24-year-old male patient operated for C5–6 fracture dislocation, presented with esophageal fistula 1 month after surgery. Investigations were done to localize the site of fistula but definitive site of leak could not be identified. Patient was counselled regarding possible surgical intervention; however, patient was opted for conservative treatment. Conclusion Esophageal fistula is a very rare occurrence. Because of varied clinical presentation and frequent delay in diagnosis, a very high index of suspicion should always be kept in mind while evaluating a patient postoperatively for dysphagia. Timely diagnosis and early intervention are key to a successful outcome.

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“…Se manifiesta en general entre los días 7 y 10 del postoperatorio (PO), aunque hay casos de aparición tardía, más de 30 días (1,3). Esta complicación puede presentarse también en otras cirugías cervicales (faringe, esófago, columna cervical) y de cavidad oral (4,5).…”

Section: Introduccionunclassified

Use of the sternocleidomastoid muscle collar flap in the surgical treatment of the pharyngostoma. Case report and literature review

Ruíz

Osorio

Persano

et al. 2017

An. Fac. Cienc. Méd. (Asunción)

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REPORTE DE CASOUtilización del colgajo muscular en collar del esternocleidomastoideo en el tratamiento quirúrgico del faringostoma. Presentación de un caso y revisión de la literatura Use of the sternocleidomastoid muscle collar flap in the surgical treatment of the pharyngostoma. Case report and literature review RESUMENLa fístula faringocutánea se define como una dehiscencia del cierre de la mucosa faríngea, que produce fuga de saliva y comunicación de la luz faríngea con la piel. Puede clasificarse en fístula propiamente dicha, en el que un trayecto fistuloso comunica luz del tubo digestivo con el exterior y en faringostoma en el que la luz de la faringe se abre directamente al exterior con pérdida importante de tejidos blandos. Es una complicación frecuente tras cirugías abiertas de laringe, pudiendo también aparecer tras cirugías de faringe, de columna espinal, reconstrucciones mandibulares así como en cirugías del piso de boca.Si bien pueden cerrar espontáneamente o con tratamiento conservador, muchas de ellas, sobre todo cuando existe una comunicación amplia entre la faringe y la piel, requieren de cirugía. Existen varias técnicas quirúrgicas para cerrar dichas fístulas. Se presenta un caso en el que se realizó la excéresis de un tumor de base de lengua sangrante, incontrolable, con una faringotomía suprahioidea como vía de abordaje, que presentó como complicación postoperatoria una fístula faringocutánea seguida de la formación de un faringostoma amplio. Fue tratado quirúrgicamente con una síntesis del defecto y refuerzo con colgajo muscular en collar con el fascículo esternal bilateral de esternocleidomastoideo. El paciente presentó buena evolución con cierre de la fístula.Palabras Clave: fistula faringocutánea -faringostoma -cierre -colgajo -esternocleidomastoideo. ABSTRACTPharyngocutaneous fistula is defined as a dehiscence of the closing of the pharyngeal mucosa, which produces leakage of saliva and communication of pharyngeal light with the skin. It can be classified as a fistula proper, in which a fistulous tract communicates light from the digestive tract with the outside and in a pharyngostoma in which the pharyngeal lumen opens directly to the outside with significant loss of soft tissues. It is a frequent complication after open surgeries of the larynx, and may also appear after surgery of the pharynx, spinal column, mandibular reconstructions as well as surgeries of the floor of the mouth. Although they can close spontaneously or with conservative treatment, many of them, especially when there is a wide communication between the pharynx and the skin, require surgery. There are several surgical techniques to close these fistulas. We present a case in which the excresis of a tongue-based tumor was performed, due to uncontrollable bleeding, with a suprahyoid pharyngotomy as the approach, presenting as a postoperative complication a pharyngocutaneous fistula followed by the formation of a broad pharyngostoma. He was treated surgically with a synthesis of the defect and reinforcement with a muscular...

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Sternocleidomastoid flap for repair of pharyngocutaneous fistula following anterior cervical spine surgery

Cited by 3 publications

References 0 publications

Pharyngocutaneous fistula and horner's syndrome following loosening of locking screw of anterior cervical plating: A rare case report and management

Pharyngocutaneous fistula and horner's syndrome following loosening of locking screw of anterior cervical plating: A rare case report and management

Esophageal Fistula following Anterior Cervical Discectomy and Fusion in Traumatic Cervical Injury Cases: A Review

Use of the sternocleidomastoid muscle collar flap in the surgical treatment of the pharyngostoma. Case report and literature review

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