title: Successful repair of esophageal perforation after anterior cervical fusion for cervical spine fracture.
abstract: Esophageal injury after anterior cervical discectomy and fusion (ACDF) is a rare complication that can be life threatening. The sternocleidomastoid (SCM) pedicled muscle flap has emerged as an effective and versatile tool for selected esophageal perforations. The authors report their surgical experience in three patients with an esophageal perforation after ACDF, and the steps taken to achieve successful repair using a SCM muscle flap. All three patients underwent ACDF at another hospital. Postoperatively, patients complained of severe dysphagia, neck swelling, fever, and alimentary fluid leakage. They were later referred to the author's hospital for diagnostic evaluation and surgical treatment of an esophageal perforation. Esophageal perforation was diagnosed on esophagoscopy and esophagography, and treated by primary closure using an SCM muscle flap. Postoperatively, all patients had a good result. Surgery-related complications occurred in one patient with dysfunction of the recurrent laryngeal nerve. This study shows that esophagoscopic diagnosis and surgical treatment using a SCM muscle flap is highly effective in patients with an esophageal perforation related to ACDF.
authors.affiliation: Department of Neurosurgery Samsung Medical Center, Sungkyunkwan University, School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea.
authors.forename: Song-Ho
authors.initials: SH
authors.lastname: Ahn
authors.forename: Sun-Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Eun Sang
authors.initials: ES
authors.lastname: Kim
authors.forename: Whan
authors.initials: W
authors.lastname: Eoh
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery*; D004939:Esophageal Perforation / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D016896:Treatment Outcome