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Eur Arch Otorhinolaryngol. 2013 Jan;270(1):277-80. doi: 10.1007/s00405-012-1992-9. Epub 2012 Mar 21.

Necrotizing fasciitis of the neck after total laryngectomy.

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  • 1Department of ENT, Head and Neck Surgery, General Hospital Dr. Josip Bencevic, Osijek School of Medicine, Josip Juraj Strossmayer University, Andrije Stampara 42, 35000, Slavonski Brod, Croatia.

Abstract

Necrotizing fasciitis (NF) is an unusual, life threatening, rapidly advancing infection characterized by widespread fascial and subcutaneous tissue necrosis and gangrene of the skin. It most commonly affects the extremities, abdominal wall and perineum, whereas cervical NF is rare. NF of the head and neck is often caused by both aerobic and anaerobic microorganisms found in the upper aerodigestive tract. Usually, cervical NF originates from odontogenic, tonsillar and pharyngeal infection, and it is very rarely a complication of surgical procedure. Without immediate surgical treatment, cervical NF leads to mediastinitis and fatal sepsis. There is only one case of cervical NF after total laryngectomy described in the literature. We report two cases of cervical NF after total laryngectomy, selective neck dissection and primary vocal prosthesis insertion. In both cases, the infection spreads to thoracic region and in one of them NF was associated with Lemierre's syndrome, i.e., thrombosis of the internal jugular vein. In both patients, vocal prosthesis was inserted during the infection and did not influence the healing process.

PMID:
22430034
[PubMed - indexed for MEDLINE]
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