Bolzoni Andrea, Peretti Giorgio, Piazza Cesare, Farina Davide, Nicolai Piero
Department of Otorhinolaryngology, University of Brescia, Spedali Civili, Piazza Spedali Civili 1, 25123 Brescia, Italy.
Head Neck. 2006 Jan;28(1):89-93. doi: 10.1002/hed.20311.
Tracheoesophageal puncture has excellent voice rehabilitation after total laryngectomy. However, despite its easy insertion and use, severe complications have been reported.
We report a case of cervical spondylodiscitis, occurring in a 67-year-old woman submitted to phonatory prosthesis insertion. After 1 month, she complained of severe cervicalgia associated with fever. Spondylodiscitis involving C6, C7, and the intervening vertebral disk with medullary compression was detected by means of imaging studies.
A right cervicotomy with drainage of necrotic tissue was performed, and a de-epithelialized fasciocutaneous deltopectoral flap was interposed between the neopharynx-esophagus and the prevertebral fascia to protect the neurovascular axis. MR performed 1 month later showed a complete resolution of the infectious process.
Severe neck pain after tracheoesophageal puncture should alert the physician about the possibility of a cervical spondylodiscitis. MR is the most useful imaging technique for preoperative and postoperative evaluation. When neurologic symptoms are detected, surgical exploration of the neck is mandatory.
全喉切除术后气管食管穿刺具有出色的语音康复效果。然而，尽管其插入和使用简便，但仍有严重并发症的报道。
我们报告一例颈椎间盘炎病例，发生在一名接受发音假体植入的67岁女性身上。1个月后，她主诉严重颈痛并伴有发热。通过影像学检查发现颈椎间盘炎累及C6、C7以及其间的椎间盘，并伴有脊髓受压。
进行了右侧颈切开术，引流坏死组织，并在新形成的咽食管与椎前筋膜之间置入去上皮化的胸大肌皮瓣，以保护神经血管轴。1个月后进行的磁共振成像显示感染过程完全消退。
气管食管穿刺后出现严重颈部疼痛应提醒医生注意颈椎间盘炎的可能性。磁共振成像是术前和术后评估最有用的影像学技术。当检测到神经症状时，必须对颈部进行手术探查。
