Management of Pharyngeal Fistulas After Anterior Cervical Spine Surgery: A Treatment Algorithm for Severe Complications.

Détails

ID Serval
serval:BIB_EC88C689CC16
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Management of Pharyngeal Fistulas After Anterior Cervical Spine Surgery: A Treatment Algorithm for Severe Complications.
Périodique
Clinical spine surgery
Auteur⸱e⸱s
Simon C., Fürstenberg C.H., Eichler M., Rohde S., Bulut C., Wiedenhöfer B.
ISSN
2380-0194 (Electronic)
ISSN-L
2380-0186
Statut éditorial
Publié
Date de publication
18/05/2016
Peer-reviewed
Oui
Volume
30
Numéro
1
Pages
E25-E30
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Retrospective database- query to identify all anterior spinal approaches.
To assess all patients with pharyngo-cutaneous fistulas after anterior cervical spine surgery.
Patients treated in University of Heidelberg Spine Medical Center, Spinal Cord Injury Unit and Department of Otolaryngology (Germany), between 2005 and 2011 with the diagnosis of pharyngo-cutaneous fistulas.
We conducted a retrospective study on 5 patients between 2005 and 2011 with PCF after ACSS, their therapy management and outcome according to radiologic data and patient charts.
Upon presentation 4 patients were paraplegic. 2 had PCF arising from one piriform sinus, two patients from the posterior pharyngeal wall and piriform sinus combined and one patient only from the posterior pharyngeal wall. 2 had previous unsuccessful surgical repair elsewhere and 1 had prior radiation therapy. In 3 patients speech and swallowing could be completely restored, 2 patients died. Both were paraplegic. The patients needed an average of 2-3 procedures for complete functional recovery consisting of primary closure with various vascularised regional flaps and refining laser procedures supplemented with negative pressure wound therapy where needed.
Based on our experience we are able to provide a treatment algorithm that indicates that chronic as opposed to acute fistulas require a primary surgical closure combined with a vascularised flap that should be accompanied by the immediate application of a negative pressure wound therapy. We also conclude that particularly in paraplegic patients suffering this complication the risk for a fatal outcome is substantial.

Pubmed
Création de la notice
04/06/2013 13:31
Dernière modification de la notice
20/08/2019 16:14
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