title: Cervical osteomyelitis after carbon dioxide laser excision of recurrent carcinoma of the posterior pharyngeal wall.
abstract: Two patients with recurrent carcinoma of the posterior pharyngeal wall, previously treated with carbon dioxide (CO2) laser excision and (chemo)radiotherapy, presented with neck pain due to cervical osteomyelitis. In one patient this led to cervical spine instability, for which a haloframe was applied. Our working hypothesis was that cervical osteomyelitis was caused by an infected wound bed induced by CO2 laser excision of the tumor in the already vascular-compromised area of the irradiated posterior pharyngeal wall. We discuss the risks of leaving a wound for secondary granulation after CO2 laser excision of the posterior pharyngeal wall and prophylactic antibiotic treatment.
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: A Jacqueline
authors.initials: AJ
authors.lastname: Timmermans
authors.forename: Dieta
authors.initials: D
authors.lastname: Brandsma
authors.forename: Ludi E
authors.initials: LE
authors.lastname: Smeele
authors.forename: Andert W
authors.initials: AW
authors.lastname: Rosingh
authors.forename: Michiel W M
authors.initials: MW
authors.lastname: van den Brekel
authors.forename: Peter J F M
authors.initials: PJ
authors.lastname: Lohuis
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002574:Cervical Vertebrae; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D054020:Lasers, Gas / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010019:Osteomyelitis / Q000209:etiology* / Q000473:pathology; D010610:Pharyngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D013122:Spinal Diseases / Q000209:etiology*; D000077195:Squamous Cell Carcinoma of Head and Neck