Pharyngeal diverticulum- a delayed complication of anterior cervical spine surgery
Abstract
Anterior cervical spine surgery (ACSS) is
an established treatment for cervical
spinedisorders and trauma. Pharyngeal
diverticulum is a rare complication after
ACSS and not well documented. Here
we describe a patient who developed
pharyngeal diverticulum after 5 years of
ACSS for trauma. Pharyngeal diverticulum
and dysphagia were persisted even
after removal of plate and screws
(elsewhere).He presented to us with dysphagia,
weight loss and fistula of left
neck with salivary and food discharge.
Investigations revealed posterior pharyngeal
diverticulum with fistula which opens
in left posterior triangle of neck. Since
the pharyngeal diverticulum was densely
adherent with Prevertebral fascia, he underwent
partial excision of diverticulum
and fistulous tract with surrounding pharyngeal
muscles reinforcement.
On follow up (20 months post surgery), the
patient remained in good condition with no
further complications or neck discharge.
This case was presented for its rarity and
the need of long term X ray follow up after
anterior cervical spine surgery..
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Pollock RA, Purvis JM, Apple DF Jr,
Murray HH (1981).Esophageal and hypopharyngeal
injuries in patients with cervical spine
trauma. Ann Otol Rhinol Laryngol 90:323
–327
Witwer BP, Resnick DK (2003) Delayed
esophageal injury without instrumentation
failure:
complication of anterior cervical instrumentation.
J Spinal Disord Tech 16:519–
Hanci M, Toprak M, Sarioglu AC, Kaynar
MY, Uzan M, Islak C (1995) Oesop
h a g e a l p e r f o r a t i o n
subsequent to anterior cervical spine
screw/plate xation. Paraplegia 33:606–
0 9
Ferreira LE, Simmons DT, Baron TH
(2008) Zenker’s diverticula: pathophysiology,
clinicalpresentation, and exible
endoscopic management. Dis Esophagus
:1–8.doi:10.1111/j.1442-
2007.00795.x
Gaudinez RF, English GM, Gebhard
JS, Brugman JL, Donaldson DH, Brown
CW (2000)Esophageal perforations after
anterior cervical surgery. J Spinal Disord
(1):77–84
Orlando ER, Caroli E, Ferrante L
(2003) Management of the cervical
esophagus andhypofarinx perforations
complicating anterior cervical spine surgery.
Spine 28(15):E290–E295
Tew JM, Mayeld FH. Complications of
surgery of the anterior cervical spine.
Clin Neurosurg.1975;23:424–434.
van Berge Henegouwen DP, Roukema
JA, de Nie JC, et al.Esophageal perforation
duringsurgery on the cervical
spine.Neurosurg. 1991;29:766–768
Konstantakos AK, Temes T (2005)
Delayed esophageal perforation: a
complication ofanterior cervical spine
xation. Ann Thorac Surg 80:349
Cook IJ, Gabb M, Panagopoulos
V, Jamieson GG, Dodds WJ,Dent J,
et al: Pharyngeal(Zenker’s) diverticulum
is a disorder of upper esophageal
sphincter opening. Gastroenterology103:
–1235, 1992
Evander A, Little AG, Ferguson
MK, Skinner DB: Diverticula of the
m i d - a n d l o w e r e s o p h a -
gus:pathogenesis and surgical management.
World J Surg 10:820–828,
Joanes V, Belinchon J (2008)
Pharyngoesophageal Diverticulum
following cervical corpectomy and
plating. Case report. J Neurosurg
Spine 9:258–260
Tian H, Yuan W , Johnson JS
etal.Pharyngoesophageal diverticulum:
a delayed complication of anterior
cervical spine surgery. Eur Spine
J (2011) 20 (Suppl 2):S211–S216
Pichler W, Maier A, Rappl T,
Clement HG, Grechenig W (2006)
Delayed hypopharyngeal and esophageal
perforation after anterior spinal
fusion: primary repair reinforced
by pedicled pectoralis major ap.
Spine (Phila Pa 1976) 31:E268–
E270.doi:10.1097/01.brs.0000215012
.84443.c2
Roche M, Gilly F, Carret JP,
Guibert B, Braillon G, Dejour H (1989)
Perforation of the cervicalesophagus
and hypopharynx complicating surgery
by an anterior approach to the cervical
spine. Ann Chir 43:343–347
Ba AM, LoTempio MM, Wang MB
(2006) Pharyngeal diverticulum as a sequela
of anterior cervical fusion. Am J
Otolaryngol 27:295–297.
Lamesch P, Dralle H, Blauth M, Hauss
J, Meyer HJ (1997) Perforation of the cervicalesophagus
after ventral fusion of the
cervical spine. Defect coverage by muscle-
plasty with thesternocleidomastoid
muscle: case report and review of the literature.
Chirurg 68:543–547
Seidl RO, Niedeggen A, Todt I, Westhofen
M, Ernst A (2007) Infrahyoid muscle
ap for pharyngealstulae after cervical
spine surgery: a novel approach—report
of six cases. Eur Spine J16:501–505.
Reid RR, Dutra J, Conley DB, Ondra
SL, Dumanian GA (2004) Improved repair
of cervicalesophageal stula complicating
anterior spinal fusion: free omental ap
compared with pectoralis major ap. Report
of four cases. J Neurosurg 100:66–
Jones WG 2nd, Ginsberg RJ (1992)
Esophageal perforation: a continuing
challenge. Ann Thorac Surg 53:534–543
Goffart Y, Moreau P, Lenelle J,
Boverie J (1991) Traction diverticulum of
the hypopharynxfollowing anterior cervical
spine surgery. Case report and review.
Ann
Salam MA, Cable HR (1994) Acquired
pharyngeal Diverticulum following
anterior cervical fusion operation.
Br J Clin Pract 48:109–110
Sood S, Henein RR, Girgis B
(1998) Pharyngeal pouch following
anterior cervical fusion. J Laryngol
Otol 112:1085–1086
Summers LE, Gump WC, Tayag
EC, Richardson DE (2007) Zenker
diverticulum: a rare complication after
anterior cervical fusion. J Spinal
Disord Tech 20:172–175.
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