Plastic and Reconstructive Surgery, Global Open (Jan 2022)

A Surgical Alternative in the Treatment of Hypopharyngeal Perforation

  • Nicolas M. Abboud, MD,
  • Melvin Dziubek, MD,
  • Svetlana Bogaert, MD,
  • Meriem Ennaji, MD,
  • Julien Spitaels, MD,
  • Vanessa Marron Mendes, MD,
  • Alessandro Fouarge, MD,
  • Maarten Vander Kuylen, MD,
  • Nicolas Cuylits, MD

DOI
https://doi.org/10.1097/GOX.0000000000004029
Journal volume & issue
Vol. 10, no. 1
p. e4029

Abstract

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Summary:. Pharyngo-esophageal perforation is a rare, life-threatening complication of anterior cervical discectomy and fusion surgery with an incidence estimated to be between 0.2 and 1.51%. Early diagnosis and appropriate treatment of this complication is the key to reduce morbidity and mortality, as the main prognostic factor is the interval between the onset of the fistula, diagnosis and treatment. Conservative management has shown encouraging results in small and localized defects, whereas surgical approaches using flaps are to be considered for most of the cases. However, there is no clear consensus on the first choice of treatment in esophageal perforation. This case report presents the use of a supra-clavicular fascio-cutaneous pedicled propeller flap as a patch combined to primary repair of a hypopharyngeal perforation, 10 years after anterior cervical spine arthrodesis.