title: Cervical oesophageal and hypopharyngeal perforations after anterior cervical spine surgery salvaged with regional and free flaps.
abstract: OBJECTIVE
  The object of the study was to present our own experience in the management of cervical oesophageal and hypopharyngeal perforations after anterior cervical spine surgery.
  
  
  METHODS
  The study group consists of 5 patients treated in Department of Otolaryngology Poznan University of Medical Sciences in 2009-2011. Different materials and techniques were used to repair the perforations: infrahyoid flap, primary sutures supported by sternocleidomastoid muscle flap, thigh flap and forearm flap in two cases.
  
  
  RESULTS
  Four out of 5 patients were referred to our department in a poor general condition, with infected neck fistulas, three patients after prolonged conservative treatment, and three patients after initial attempts to repair the perforation outside our institution. One-stage reconstructive surgery was successful in three cases, while in two others secondary interventions were necessary. Total hospital stay ranged in the analysed group from 23 to 191 days, hospital stay in our department from 1 to 62 days, hospital stay from the final procedure from 18 to 26 days. Swallowing function was within normal limits in all cases 12-14 days after the surgery.
  
  
  CONCLUSIONS
  The authors' experience shows that in long-lasting and infected cervical oesophageal and hypopharyngeal perforations following anterior cervical spine surgery distant flaps should be primarily used as a source of a well-vascularized and unchanged tissue. It seems to be crucial to repair the perforations immediately after the first symptoms appear - such an approach significantly reduces total hospital stay and improves the prognosis.
authors.affiliation: Klinika Otolaryngologii i Onkologii Laryngologicznej, Uniwersytet Medyczny, ul. Przybyszewskiego 49, Poznań.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Wierzbicka
authors.forename: Anna
authors.initials: A
authors.lastname: Bartochowska
authors.forename: Jacek
authors.initials: J
authors.lastname: Banaszewski
authors.forename: W
authors.initials: W
authors.lastname: Szyfter
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery*; D004939:Esophageal Perforation / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D007013:Hypopharynx / Q000293:injuries* / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects; D011044:Poland; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation; D016879:Salvage Therapy; D055815:Young Adult