Cervical spondylodiscitis: a rare complication after phonatory prosthesis insertion.
BACKGROUND
Tracheoesophageal puncture has excellent voice rehabilitation after total laryngectomy. However, despite its easy insertion and use, severe complications have been reported.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Bolzoni
Andrea
A
Department of Otorhinolaryngology, University of Brescia, Spedali Civili, Piazza Spedali Civili 1, 25123 Brescia, Italy.
Peretti
Giorgio
G
Piazza
Cesare
C
Farina
Davide
D
Nicolai
Piero
P
D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D015299:Discitis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D004947:Esophagus / Q000601:surgery; D005260:Female; D006801:Humans; D007825:Laryngectomy; D007831:Larynx, Artificial / Q000009:adverse effects*; D019547:Neck Pain; D017755:Prosthesis Fitting; D011677:Punctures / Q000009:adverse effects; D013064:Speech Disorders / Q000209:etiology / Q000534:rehabilitation; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000601:surgery