Cover Image

Pharyngeal diverticulum- a delayed complication of anterior cervical spine surgery

ANBALAGAN ANBALAGAN

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..


Full Text:

PDF

References


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.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

An Initiative of The Tamil Nadu Dr MGR Medical University