{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T07:27:27Z","timestamp":1768289247698,"version":"3.49.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2]]},"abstract":"\n Study Design:<\/jats:title>\n This study is a retrospective database query to identify all anterior spinal approaches.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n The objectives were to assess all patients with pharyngocutaneous fistulas (PCFs) after anterior cervical spine surgery.<\/jats:p>\n <\/jats:sec>\n \n Summary of Background Data:<\/jats:title>\n Patients with the diagnosis of PCFs were treated at the University of Heidelberg Spine Medical Center, Spinal Cord Injury Unit and Department of Otolaryngology (Germany), between 2005 and 2011.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We conducted a retrospective study on 5 patients with PCF after anterior cervical spine surgery between 2005 and 2011 and analyzed their therapy management and outcome on the basis of the radiologic data and patient charts.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Upon presentation, 4 patients were paraplegic. Two patients had PCF arising from 1 piriform sinus, 2 patients had PCF arising from the posterior pharyngeal wall and piriform sinus combined, and 1 patient had PCF arising only from the posterior pharyngeal wall. Two patients previously underwent unsuccessful surgical repair elsewhere and 1 patient underwent a prior radiation therapy. In 3 patients, speech and swallowing could be completely restored. Two patients died, both of whom were paraplegic. The patients were needed to undergo an average of 2 or 3 procedures for complete functional recovery of primary closure with various vascularized regional flaps and refining laser procedures supplemented with the negative pressure wound therapy wherever needed.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n On the basis of our experience, we are able to provide a treatment algorithm that indicates that chronic, as opposed to acute, fistulas require a primary surgical closure combined with a vascularized flap that should be accompanied by the immediate application of a negative pressure wound therapy. We also conclude that particularly in paraplegic patients suffering from this complication the risk for a fatal outcome is substantial.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bsd.0b013e3182999504","type":"journal-article","created":{"date-parts":[[2013,5,22]],"date-time":"2013-05-22T12:37:57Z","timestamp":1369226277000},"page":"E25-E30","source":"Crossref","is-referenced-by-count":4,"title":["Management of Pharyngeal Fistulas After Anterior Cervical Spine Surgery"],"prefix":"10.1097","volume":"30","author":[{"given":"Christian","family":"Simon","sequence":"first","affiliation":[{"name":"Service d\u2019oto-rhino-laryngologie (ORL), Centre Hospitalier Universitaire Vaudois, Universit\u00e9 de Lausanne, Lausanne, Suisse"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl H.","family":"F\u00fcrstenberg","sequence":"additional","affiliation":[{"name":"Orthopedics, Trauma Surgery and Spinal Cord Injury"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Eichler","sequence":"additional","affiliation":[{"name":"Orthopedics, Trauma Surgery and Spinal Cord Injury"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Rohde","sequence":"additional","affiliation":[{"name":"Neuroradiology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cem","family":"Bulut","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2014Head and Neck Surgery, University of Heidelberg, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernd","family":"Wiedenh\u00f6fer","sequence":"additional","affiliation":[{"name":"Orthopedics, Trauma Surgery and Spinal Cord Injury"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230831","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.surneu.2007.05.006","article-title":"Esophageal injury associated with anterior cervical spine surgery","volume":"69","author":"Patel","year":"2008","journal-title":"Surg Neurol"},{"key":"R2-20230831","first-page":"175","article-title":"Complications of anterior cervical disc operation and their treatment","volume":"69","author":"Cloward","year":"1971","journal-title":"Surgery"},{"key":"R3-20230831","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1093\/neurosurgery\/23.CN_suppl_1.424","article-title":"Complications of surgery of the anterior cervical spine","volume":"23","author":"Tew","year":"1976","journal-title":"Clin Neurosurg"},{"key":"R4-20230831","first-page":"E5","article-title":"Esophageal perforation in closed neck trauma","volume":"50","author":"Henderson","year":"2007","journal-title":"Can J Surg"},{"issue":"pt 1","key":"R5-20230831","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1177\/000348948109000406","article-title":"Esophageal and hypopharyngeal injuries in patients with cervical spine trauma","volume":"90","author":"Pollock","year":"1981","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"R6-20230831","doi-asserted-by":"crossref","first-page":"541","DOI":"10.3171\/jns.1980.53.4.0541","article-title":"Hyperextension injury of the cervical spine with esophageal perforation. 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