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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
- Source :
- World Neurosurgery. 141:219-225
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Pharyngoesophageal injury during anterior cervical spine surgery is a rare and potentially life-threatening complication; generally it is the result of intraoperative manipulation or hardware erosion and sometimes may be due to weakness of the pharyngoesophageal wall from pre-existing pathologic conditions, such as diabetes, gastritis, or obesity.We describe the management strategies in patients with an early postoperative hypopharyngeal perforation that occurred after anterior cervical spine surgery without failure of instrumentation, and we present a case treated endoscopically at our institution.Appropriate treatment for pharyngoesophageal perforations is controversial and not investigated in detail. There is a lack of prospective studies comparing initial conservative versus surgical approaches to treatment. In addition, endoscopic management is growing as a therapeutic option, but no consensus concerning the indications for an endoscopic approach in the treatment of pharyngoesophageal injury in anterior cervical spine surgery is currently reached. A common theme proposed in the literature is that early recognition and aggressive investigation and treatment are essential to ensure a good outcome. A customized interdisciplinary surgical approach is essential for successful treatment. Use of the transoral endoscopic approach is a useful noninvasive method to treat this rare but potentially devastating complication.
- Subjects :
- Male
Cervical spine surgery
Weakness
medicine.medical_specialty
Laryngoscopy
Perforation (oil well)
Endoscopic management
03 medical and health sciences
0302 clinical medicine
medicine
Humans
In patient
Prospective cohort study
Esophageal Perforation
medicine.diagnostic_test
business.industry
Endoscopy
Middle Aged
Surgery
anterior cervical spine surgery
laryngoscopy
neurosurgery complication
pharyngoesophageal perforation
transoral endoscopic
Spinal Fusion
030220 oncology & carcinogenesis
Cervical Vertebrae
Pharynx
Neurology (clinical)
medicine.symptom
Complication
business
Intervertebral Disc Displacement
030217 neurology & neurosurgery
Diskectomy
Subjects
Details
- ISSN :
- 18788750
- Volume :
- 141
- Database :
- OpenAIRE
- Journal :
- World Neurosurgery
- Accession number :
- edsair.doi.dedup.....a04b6b2828089bfc93c9a5e3edb94166