Cervical spondylodiscitis following an invasive process on the neopharynx after circumferential pharyngolaryngectomy: a retrospective case sequence.
Eur Backbone J. 2016 Dec;25(12):3894-3901
Authors: Espitalier F, de Keating-Hart A, Morinière S, Badet JM, Asseray N, Ferron C, Malard O
PURPOSE: To focus on cervical spondylodiscitis as an rare complication following an invasive process on the neopharynx in sufferers beforehand handled with circumferential pharyngolaryngectomy with pectoralis main myocutaneous flap reconstruction.
METHODS: Sufferers recognized with cervical spondylodiscitis after circumferential pharyngolaryngectomy between 2001 and 2013 had been retrospectively studied utilizing a questionnaire despatched to the French head and neck tumour examine group. Medical historical past; tumour administration; medical signs; organic, microbiological and imaging outcomes; and administration of the an infection had been collected for every affected person.
RESULTS: Six males aged 51-66 years had been recognized with spondylodiscitis on common 5.6 years after circumferential pharyngolaryngectomy, and a imply 2 months following an invasive process on the neopharynx (oesophageal dilatation, phonatory prosthesis insertion). The sufferers offered with cervical ache and elevated CRP degree. MRI confirmed epidural abscess and communication between the pharynx and vertebral our bodies usually. Microbiological samples yielded micro organism from the pharynx flora. An infection was managed utilizing antibiotics adjusted in line with the tradition outcomes and spinal immobilisation for length of 6-12 weeks. No surgical therapy was required. Throughout follow-up, no affected person skilled recurrence or residual incapacity.
CONCLUSIONS: Cervical spondylodiscitis is a uncommon however doubtlessly extreme complication following an invasive process on the neopharynx after circumferential pharyngolaryngectomy. Subsequently, the onset of nonspecific signs shouldn’t be neglected, and MRI should be carried out if an infection is suspected. Microbiological affirmation is important in optimising therapy, which ought to be aggressive, even when total prognosis appears to be good.
PMID: 27566300 [PubMed – indexed for MEDLINE]