title: Cervical spondylodiscitis: a rare complication after phonatory prosthesis insertion.
abstract: 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.
authors.affiliation: Department of Otorhinolaryngology, University of Brescia, Spedali Civili, Piazza Spedali Civili 1, 25123 Brescia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bolzoni
authors.forename: Giorgio
authors.initials: G
authors.lastname: Peretti
authors.forename: Cesare
authors.initials: C
authors.lastname: Piazza
authors.forename: Davide
authors.initials: D
authors.lastname: Farina
authors.forename: Piero
authors.initials: P
authors.lastname: Nicolai
mesh_terms: 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