title: Hypopharyngeal injury leading to subcutaneous emphysema after anterior cervical discectomy and artificial cervical disc placement.
abstract: Anterior cervical discectomy and fusion (ACDF) may lead to complications such as dysphagia, hoarseness, recurrent laryngeal nerve palsy, vocal cord palsy, dural tears with leakage of cerebrospinal fluid, haematoma, and oesophageal and vascular injuries. Hypopharyngeal injury in the early postoperative period is a rare, but life-threatening, problem. We present a patient with dyspnoea who developed subcutaneous emphysema in the early postoperative period after an iatrogenic hypopharyngeal injury following ACDF. These complications prolonged the postoperative course of the patient. The role of careful surgical intervention, and anticipation of potential complications, has been emphasized, especially when surgical exposure of the anterior spinal canal above C(4) is required.
authors.affiliation: Department of Neuroanaesthesiology, Neurosciences Center, 6th Floor, Room No. 9, All India Institute of Medical Sciences, New Delhi 110029, India. girijarath@yahoo.co.in
authors.forename: Girija P
authors.initials: GP
authors.lastname: Rath
authors.forename: Manish
authors.initials: M
authors.lastname: Marda
authors.forename: Navdeep
authors.initials: N
authors.lastname: Sokhal
authors.forename: Pankaj
authors.initials: P
authors.lastname: Singh
authors.forename: P Sarat
authors.initials: PS
authors.lastname: Chandra
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D017586:Diskectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007013:Hypopharynx / Q000293:injuries* / Q000473:pathology; D007049:Iatrogenic Disease / Q000517:prevention & control; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D019736:Prostheses and Implants / Q000009:adverse effects; D019919:Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D013352:Subcutaneous Emphysema / Q000175:diagnosis / Q000209:etiology*; D013525:Surgical Instruments / Q000009:adverse effects; D014132:Trachea / Q000473:pathology