scholarly journals Delayed onset postoperative retropharyngeal hematoma after anterior cervical surgery with a sequela of tracheal stricture: a case report

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Dong-Gune Chang ◽  
Jong-Beom Park ◽  
Hong Jin Kim ◽  
Soo-Bin Park
Keyword(s):  
Endotracheal Intubation ◽  
Lateral Displacement ◽  
Airway Compromise ◽  
Hematoma Evacuation ◽  
Delayed Onset ◽  
First Case ◽  
Cervical Surgery ◽  
Retropharyngeal Hematoma ◽  
Anterior Cervical Surgery ◽  
Tracheal Stricture

Abstract Background Among the several complications associated with anterior cervical discectomy and fusion (ACDF), airway compromise is considered one of the serious life-threatening conditions and usually requires emergent treatment, including airway establishment and hematoma evacuation surgery. Postoperative retropharyngeal hematoma commonly occurred during the on immediate phase with airway compromise, but have a rarity on late onset of this complication. Enlightened by this existing fact, we report the first case of delayed onset postoperative retropharyngeal hematoma after anterior cervical surgery with a sequela of tracheal stricture. Case presentation A 55-year-old male underwent ACDF for disc herniation at C5–6 that had not responded to conservative treatment over 3 months. The symptoms significantly improved after surgery, and he was discharged on postoperative day 3. On the 7 days after ACDF, the patient complained of sudden-onset left-deviated neck swelling. The follow-up plain radiographs and neck-enhanced computed tomography (CT) scans showed anterior and right lateral displacement of the airway including the trachea by a large retropharyngeal hematoma. We performed an emergent forceful endotracheal intubation that was maintained for 2 days until the patient underwent hematoma evacuation surgery. On the second day after hematoma evacuation surgery, the patient complained of hoarseness with a foul breath odor. Laryngoscopy showed tracheal ischemic mucosal damage that had been induced by forceful endotracheal intubation. Antibiotics and systemic corticosteroids were administered, and the symptoms improved. One month after hematoma evacuation surgery, he complained of dyspnea on exertion, and laryngoscopy showed tracheal stricture. The patient underwent bronchoscopic dilatation and is doing well without recurrence of symptoms. Conclusions Early surgery to remove the delayed onset retropharyngeal hematoma, rather than forceful endotracheal intubation followed by delayed surgery, might yield better results and avoid unexpected complications of tracheal stricture.

scholarly journals Delayed Onset Postoperative Retropharyngeal Hematoma After Anterior Cervical Surgery With a Sequela of Tracheal Stricture: a Case Report

2021 ◽  
Author(s):  
Dong-Gune Chang ◽  
Jong-Beom Park ◽  
Zin Ouk Hwang ◽  
Hong Jin Kim
Keyword(s):  
Endotracheal Intubation ◽  
Lateral Displacement ◽  
Airway Compromise ◽  
Hematoma Evacuation ◽  
Delayed Onset ◽  
First Case ◽  
Cervical Surgery ◽  
Retropharyngeal Hematoma ◽  
Anterior Cervical Surgery ◽  
Tracheal Stricture

Abstract Background: Among the several complications associated with anterior cervical discectomy and fusion (ACDF), airway compromise is considered one of the serious life-threatening conditions and usually requires emergent treatment, including airway establishment and hematoma evacuation surgery. Postoperative retropharyngeal hematoma commonly occurred during the on immediate phase with airway compromise but have a rarity on late onset of this complication. Enlightened by this existing fact, we report the first case of delayed onset postoperative retropharyngeal hematoma after anterior cervical surgery with a sequela of tracheal stricture. Case presentation: A 55-year-old male underwent ACDF for disc herniation at C5-6 that had not responded to conservative treatment over three months. The symptoms significantly improved after surgery, and he was discharged on postoperative day 3. On the seven days after ACDF, the patient complained of sudden onset left-deviated neck swelling. The follow-up plain radiographs and neck-enhanced computed tomography (CT) scans showed anterior and right lateral displacement of the airway including the trachea by a large retropharyngeal hematoma. We performed an emergent forceful endotracheal intubation that was maintained for two days until the patient underwent hematoma evacuation surgery. On the second day after hematoma evacuation surgery, the patient complained of hoarseness with a foul breath odor. Laryngoscopy showed tracheal ischemic mucosal damage that had been induced by forceful endotracheal intubation. Antibiotics and systemic corticosteroids were administered, and the symptoms improved. One month after hematoma evacuation surgery, he complained of dyspnea on exertion, and laryngoscopy showed tracheal stricture. The patient underwent bronchoscopic dilatation and is doing well without recurrence of symptoms. Conclusions: Early surgery to remove the delayed onset retropharyngeal hematoma, rather than forceful endotracheal intubation followed by delayed surgery, might yield better results and avoid unexpected complications of tracheal stricture.

scholarly journals Traumatic Retropharyngeal Hematoma in a Patient Taking Clopidogrel

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
David P. Betten ◽  
Jennifer L. Jaquint
Keyword(s):  
Symptom Onset ◽  
Elderly Woman ◽  
Antiplatelet Agents ◽  
Airway Compromise ◽  
Delayed Onset ◽  
Life Threatening ◽  
Retropharyngeal Hematoma ◽  
Life Threatening Event

The development of a retropharyngeal hematoma may lead to acute airway compromise requiring emergent airway stabilization. We describe the development of a retropharyngeal hematoma in an elderly woman who sustained a fall from standing approximately 10 hours prior to symptom onset who was taking the antiplatelet agents clopidogrel and aspirin. This delayed onset of rapid airway compromise secondary to a retropharyngeal hematoma following a fall in a patient taking clopidogrel is an unusual and potentially life threatening event.

scholarly journals Intraoperative O-arm Navigation Guided Anterior Cervical Surgery; A technical note and case series

2021 ◽  
pp. 101288
Author(s):  
Masato Tanaka ◽  
Hardik Suthar ◽  
Yoshihiro Fujiwara ◽  
Yoshiaki Oda ◽  
Koji Uotani ◽  
...  
Keyword(s):  
Case Series ◽  
Technical Note ◽  
Cervical Surgery ◽  
Anterior Cervical Surgery

254. Pain catastrophizing impacts outcome scores but not recovery kinetics after 1-2 level anterior cervical surgery

2021 ◽  
Vol 21 (9) ◽  
pp. S131
Author(s):  
Sohrab Virk ◽  
Avani S. Vaishnav ◽  
Hikari Urakawa ◽  
Jung Mok ◽  
Marcel Dupont ◽  
...  
Keyword(s):  
Pain Catastrophizing ◽  
Cervical Surgery ◽  
Outcome Scores ◽  
Anterior Cervical Surgery

Prolonged and severe dysphagia following anterior cervical surgery

2004 ◽  
Vol 11 (4) ◽  
pp. 424-427 ◽  
Author(s):  
Sunny King Shun Lee ◽  
Gabriel Yin Foo Lee ◽  
George Tse Hwai Wong
Keyword(s):  
Severe Dysphagia ◽  
Cervical Surgery ◽  
Anterior Cervical Surgery

scholarly journals Anterior cervical spine surgical complications: Safety comparison between teacher and student

2021 ◽  
Vol 12 ◽  
pp. 43
Author(s):  
Edvin Zekaj ◽  
Guglielmo Iess ◽  
Domenico Servello
Keyword(s):  
Critical Factor ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Complication Rates ◽  
Years Of Experience ◽  
Cervical Discectomy ◽  
Phone Calls ◽  
Cervical Surgery ◽  
Anterior Cervical Surgery

Background: Anterior cervical surgery has a widespread use. Despite its popularity, this surgery can lead to serious and life-threatening complications, and warrants the attention of skilled attending spinal surgeons with many years of experience. Methods: We retrospectively evaluated postoperative complications occurring in 110 patients who underwent anterior cervical surgery (anterior cervical discectomy without fusion, anterior cervical discectomy and fusion, and anterior cervical disc arthroplasty) between 2013 and 2020. These operations were performed by an either an attending surgeon with 30 years’ experience versus a novice neurosurgeon (NN) with <5 years of training with the former surgeon. Complications were variously identified utilizing admission/discharge notes, surgical reports, follow-up visits, and phone calls. Complications for the two groups were compared for total and specific complication rates (using the Pearson’s Chi-square and Fisher’s test). Results: The total cumulative complication rate was 15.4% and was not significantly different between the two cohorts. The most frequent postoperative complication was dysphagia. Notably, there were no significant differences in total number of postoperative instances of dysphagia, dysphonia, unintended durotomy, hypoasthenia, and hypoesthesia; the only difference was the longer operative times for NNs. Conclusion: Surgeons’ years of experience proved not to be a critical factor in determining complication rates following anterior cervical surgery.

Complications associated with anterior cervical surgery

2016 ◽  
Vol 28 (2) ◽  
pp. 118-122
Author(s):  
Jesse E. Bible ◽  
Joon Y. Lee
Keyword(s):  
Cervical Surgery ◽  
Anterior Cervical Surgery

scholarly journals An “Uncrimped” SMart Stapes Prosthesis: A Cause of Late Hearing Deterioration in Otosclerosis

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Premjit S. Randhawa ◽  
Nicholas Hamilton ◽  
Antony A. Narula
Keyword(s):  
Lateral Displacement ◽  
Success Rates ◽  
Late Failure ◽  
First Case ◽  
Initial Surgery ◽  
Hearing Thresholds ◽  
Increased Risk ◽  
Stapes Prosthesis ◽  
Cause Of Failure ◽  
Hearing Outcomes

Statement of Problem. Stapedotomy is the treatment of choice for otosclerosis. Numerous techniques and prosthesis are available to perform this procedure. Success rates of surgery vary from 17% to 80%, and revision surgery carries an increased risk of complications as well as poorer hearing outcomes.Method of Study. Case report.Results. We report the first case of uncrimping of a SMart stapes prosthesis with no lateral displacement as a cause of late failure despite successful crimping and improvement in audiological outcomes after initial surgery.Conclusion. The SMart stapes prosthesis is widely used and has been shown to be safe and provide good hearing outcomes. Displacement of a stapes prosthesis is the commonest cause of failure. Our case shows that deterioration of hearing thresholds can occur from uncrimping of the prosthesis with no displacement. It is important to improve our understanding of stapedotomy failure as revision procedures are associated with poorer outcomes.

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