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Dysphagie nach HWS-Operation

Dysphagia after ventral spondylodesis

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Zusammenfassung

Hintergrund

Komplikationen durch Osteosynthesematerial nach Operation der Halswirbelsäule stellen eine Seltenheit dar.

Patient und Methode

Es wird der Fall eines 36-jährigen Patienten dargestellt, der nach Durchführung einer ventralen Spondylodese wegen einer zervikalen Wirbelkörperfraktur postoperativ unter dysphagischen Beschwerden litt.

Ergebnisse

Bei der röntgenologischen Kontrolle der HWS fiel der Verlust einer Osteosyntheseschraube auf, welche durch die weitere Diagnostik im Rektum lokalisiert wurde und spontan ausgeschieden werden konnte. Aufgrund der fortbestehenden Dysphagie erfolgte die HNO-ärztliche Kontrolle. Endoskopisch zeigte sich an der Rachenhinterwand ein kirschgroßer granulierender Tumor, welcher abgetragen wurde. Histologisch handelte es sich um eine granulierende Entzündung. Ohne weitere Komplikationen wurde der Patient beschwerdefrei.

Schlussfolgerungen

Bei Auftreten von Dysphagiebeschwerden nach Osteosynthesen der Halswirbelsäule muss an mögliche Komplikationen durch das implantierte Material gedacht werden. Die diagnostische Klärung erfolgt durch entsprechende Röntgendiagnostik und Endoskopie. Weitere therapeutische Konsequenzen richten sich nach der individuellen Befundsituation.

Abstract

Background

Complications caused by osteosynthetic material after cervical spine surgery are rare.

Patient and method

The case of a 36-year-old patient is reported, who suffered the extrusion of a screw and migration through the hypopharynx after ventral spondylodesis of a cervical spine fracture.

Result

Dysphagia occurred shortly after spinal surgery. The lack of one osteosynthesis screw in the spine was detected by X-ray and the material was located in the rectum. The screw had passed through the intestinal tract and was excreted spontaneously. An ENT medical control was carried out because of persisting dysphagia. Endoscopy revealed a cherry-sized granuloma of the posterior hypopharynx wall which was removed surgically. The healing process of the mucosa continued without further complications.

Conclusion

X-ray control and endoscopy are required immediately when dysphagia occurs after osteosynthesis of the cervical spine due to possible complications caused by the implanted material. Further therapeutic measures depend on the case-specific constellation.

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Authors and Affiliations

  1. HNO–Klinik des MediClin–Müritz-Klinikums Waren, Weinbergstraße 19, 17192, Waren (Müritz), Deutschland

    D. Kleemann, I. Plank, S. Nofz & A. Schlottmann

  2. Neurochirurgische Klinik der MediClin-Klinik Plau am See, Plau am See, Deutschland

    S. Nazir & E. Donauer

Authors
  1. D. Kleemann
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  2. I. Plank
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  3. S. Nofz
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  4. A. Schlottmann
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  5. S. Nazir
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  6. E. Donauer
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Corresponding author

Correspondence to D. Kleemann.

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Kleemann, D., Plank, I., Nofz, S. et al. Dysphagie nach HWS-Operation. HNO 57, 621–624 (2009). https://doi.org/10.1007/s00106-009-1914-3

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  • DOI: https://doi.org/10.1007/s00106-009-1914-3

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