J Korean Neurosurg Soc.  2013 Jun;53(6):377-379. 10.3340/jkns.2013.53.6.377.

Large Perforation of Hypopharynx Secondary to Anterior Cervical Approach : A Complicated Case

• Park JH
• Do NY
• Kim SW
• Kim HS

• KMID: 2190829
• DOI: http://doi.org/10.3340/jkns.2013.53.6.377

Abstract

Perforation of the hypopharynx, which can occur after anterior cervical approach, is a very rare type of complication. If diagnosed late, it can lead to very fatal course, such as mediastinitis and hematosepsis. Therefore, a precise and prompt diagnosis is crucial. When conservative treatment alone is not expected to heal the perforated site or is likely to lead to serious complications, surgical treatment becomes necessary. This report demonstrates that surgical intervention performed immediately after an early diagnosis can lead to the successful treatment of a large perforation in the hypopharynx on a 58-year-old male patient.

Keyword

Hypopharynx; Perforation; Cervical

MeSH Terms

Early Diagnosis
Humans
Hypopharynx
Male
Mediastinitis

Figure

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  Fig. 1 Preoperative computed tomography scans show a large amount of subcutaneous emphysema in the anterior lateral cervical regions.

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  Fig. 2 Contrast study reveal a large fistulous tract and contrast leaking from the right pyriform sinus into the operation site.

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  Fig. 3 A perforation approximately 2 cm long in the right hypopharynx (arrow). Severe inflammation can be observed in the surrounding region.

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  Fig. 4 Contrast study performed at 13th day after surgery reveal the leakage, which was observed before surgery is absent.

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