Neck stiffness after transoral pharyngolaryngeal surgery for squamous cell carcinoma |
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Institution: | 1. Service d’oto-rhino-laryngologie et chirurgie cervico-faciale, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France;2. Faculté de médecine, université Paris Descartes, 75005 Paris, France |
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Abstract: | IntroductionPyogenic spondylodiscitis is a rare, destructive intervertebral disc infection.Case summaryWe describe a case of C2-C3 pyogenic spondylodiscitis after transoral surgery of the posterior pharyngeal wall in a 64-year-old man with a history of oropharyngeal squamous cell carcinoma (SCC) treated by neck irradiation (45 Gy). Ten years after initial treatment, he underwent total laryngectomy for laryngeal SCC, together with transoral resection of carcinoma in situ (CIS) of the posterior pharyngeal wall followed by BioDesign® tissue repair graft. Five months later, C2-C3 spondylodiscitis was diagnosed with the formation of a fistula between the posterior pharyngeal wall and the intervertebral disc. Antibiotic therapy was administered for a total duration of 3 months (multi-susceptible Escherichia coli). Eight months after the diagnosis of spondylodiscitis, the patient died from carotid artery rupture following another course of radiotherapy for lymph node recurrence.DiscussionLarger-scale studies are necessary to evaluate the prevalence and risk factors of radiation-induced spondylodiscitis that currently remain poorly elucidated. The best treatment strategy (choice and duration of antibiotic therapy) and the optimal frequency of follow-up must be determined and the value of preventive measures (biomaterial, flap repair) needs to be evaluated. |
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Keywords: | Cervical spondylodiscitis Transoral resection Oropharyngeal carcinoma Radiotherapy Complications of radiotherapy SCC"} {"#name":"keyword" "$":{"id":"kw0035"} "$$":[{"#name":"text" "_":"Squamous cell carcinoma CIS"} {"#name":"keyword" "$":{"id":"kw0045"} "$$":[{"#name":"text" "_":"Carcinoma in situ CRP"} {"#name":"keyword" "$":{"id":"kw0055"} "$$":[{"#name":"text" "_":"C-reactive protein Gy"} {"#name":"keyword" "$":{"id":"kw0065"} "$$":[{"#name":"text" "_":"Gray MRI"} {"#name":"keyword" "$":{"id":"kw0075"} "$$":[{"#name":"text" "_":"Magnetic resonance imaging CT"} {"#name":"keyword" "$":{"id":"kw0085"} "$$":[{"#name":"text" "_":"Computed tomography PET"} {"#name":"keyword" "$":{"id":"kw0095"} "$$":[{"#name":"text" "_":"Positron emission tomography SUV"} {"#name":"keyword" "$":{"id":"kw0105"} "$$":[{"#name":"text" "_":"Standardised Uptake Value |
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