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Suspicion of cricohyoidopexy line rupture after supracricoid partial laryngectomy and the value of computed tomography to exclude this complication

Year 2008, Volume: 18 Issue: 3, 179 - 181, 25.06.2008

Abstract

We present a 48-year-old man who underwent supracricoid partial laryngectomy with cricohyoidoepiglottopexy. He developed diffuse subcutaneous emphysema and saliva aspiration on the first postoperative day, arousing suspicion of a pexy line rupture. Palpation of the cricohyoid suture line and a lateral cervical X-ray were not helpful. Laryngeal computed tomography CT obtained demonstrated an undisturbed cricohyoidoepiglottopexy suture line. Some of the neck sutures were removed, a drain placed under the neck flap, a tight dressing applied, and surgical exploration was not necessary. Subcutaneous emphysema regressed in the following days and no other problem was seen. Air escape from the cricohyoid approximation line was attributed to subcutaneous emphysema. Following supracricoid partial laryngectomy, rupture of the cricohyoidopexy line is a rare but serious complication that needs urgent exploration. Therefore, when there is suspicion, laryngeal CT is very important to rule out this condition. Moreover, close cooperation is necessary with the radiologist who may not be familiar with disturbed anatomy by previous surgery.

References

  • Laccourreye O, Brasnu D, Laccourreye L, Weinstein G. Ruptured pexis after supracricoid partial laryngec- tomy. Ann Otol Rhinol Laryngol 1997;106:159-62.
  • Laccourreye O, Ross J, Brasnu D, Chabardes E, Kelly JH, Laccourreye H. Extended supracricoid partial laryngectomy with tracheocricohyoidoepiglottopexy. Acta Otolaryngol 1994;114:669-74.
  • Laccourreye H, Laccourreye O, Weinstein G, Menard M, Brasnu D. Supracricoid laryngectomy with cri- cohyoidopexy: a partial laryngeal procedure for selected supraglottic and transglottic carcinomas. Laryngoscope 1990;100:735-41.
  • de Vincentiis M, Minni A, Gallo A. Supracricoid laryn- gectomy with cricohyoidopexy (CHP) in the treatment of laryngeal cancer: a functional and oncologic experi- ence. Laryngoscope 1996;106:1108-14.
  • Naudo P, Laccourreye O, Weinstein G, Jouffre V, Laccourreye H, Brasnu D. Complications and func- tional outcome after supracricoid partial laryngecto- my with cricohyoidoepiglottopexy. Otolaryngol Head Neck Surg 1998;118:124-9.
  • Bron L, Brossard E, Monnier P, Pasche P. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy and cricohyoidopexy for glottic and supraglottic carci- nomas. Laryngoscope 2000;110:627-34.
  • Tuncel U, Aygenc E, Yilmaz YF, Unal A. Ruptured pexy after supracricoid partial laryngectomy: a case report. KBB-Forum Electronic Journal of Otolaryngology – Head and Neck Surgery 2003;2. Available from: http:// kbb-forum.net/journal/text.php3?id=22.
  • Brasnu DF, Hartl DM, Laccourreye H. Supracricoid par- tial laryngectomy with cricohyoidopexy. In: Weinstein GS, editor. Organ preservation surgery for laryngeal can- cer. San Diego, CA: Singular Publishing; 1999. p. 127-48.
  • Naudo P, Laccourreye O, Weinstein G, Hans S, Laccourreye H, Brasnu D. Functional outcome and prognosis factors after supracricoid partial laryngecto- my with cricohyoidopexy. Ann Otol Rhinol Laryngol 1997;106:291-6.
  • Traissac L, Verhulst J. Technical indications and results of reconstructive laryngectomies. Rev Laryngol Otol Rhinol 1991;112:55-8. [Abstract]
  • Bely-Toueg N, Halimi P, Laccourreye O, Laskri F, Brasnu D, Frija G. Normal laryngeal CT findings after supracricoid partial laryngectomy. AJNR Am J Neuroradiol 2001;22:1872-80.
  • Maroldi R, Battaglia G, Nicolai P, Maculotti P, Cappiello J, Cabassa P, et al. CT appearance of the larynx after conservative and radical surgery for carcinomas. Eur Radiol 1997;7:418-31.

Suprakrikoid parsiyel larenjektomiden sonra krikohiyoidopeksi rüptürü şüphesi ve bilgisayarlı tomografinin bu komplikasyonu dışlamadaki değeri

Year 2008, Volume: 18 Issue: 3, 179 - 181, 25.06.2008

Abstract

Bu yazıda krikohiyoidoepiglottopeksi ile suprakrikoid parsiyel larenjektomi uygulanan 48 yaşında bir erkek hasta sunuldu. Ameliyat sonrası ilk günde hastada, peksi rüptürünü akla getiren yaygın ciltaltı amfizemi ve tükürük aspirasyonu gelişti. Krikohiyoid bileşke arasındaki bağ- lantının palpasyonu ve yan servikal grafi durumu açıklı- ğa kavuşturmadı. Çekilen bilgisayarlı tomografide BT krikohiyoid bileşkede herhangi bir açıklık saptanmadı. Hastada cerrahi eksplorasyona gerek duyulmadı; cilt dikişlerinin seyreltilmesi, cilt altına Penroz dren konarak sıkı sargı yapılması sonucunda ciltaltı amfizemi birkaç gün içinde geriledi ve başka sorun görülmedi. Peksi hattından hava kaçağının ciltaltı amfizeme bağlı olduğu düşünüldü. Suprakrikoid parsiyel larenjektomi ameliya- tından sonra peksi rüptürü, ender ancak ciddi bir kompli- kasyondur ve acil eksplorasyon gerektirir. Bu durumdan süphelenildiğinde, peksi rüptürü olup olmadığını sapta- mada BT son derece önemli bir yöntemdir. Ayrıca, bu inceleme yapılırken, geçirilmiş cerrahiye bağlı bozulmuş anatomiyi tanıma zorluğu nedeniyle radyoloji uzmanı ile sıkı bir işbirliği içinde bulunulması gerekir

References

  • Laccourreye O, Brasnu D, Laccourreye L, Weinstein G. Ruptured pexis after supracricoid partial laryngec- tomy. Ann Otol Rhinol Laryngol 1997;106:159-62.
  • Laccourreye O, Ross J, Brasnu D, Chabardes E, Kelly JH, Laccourreye H. Extended supracricoid partial laryngectomy with tracheocricohyoidoepiglottopexy. Acta Otolaryngol 1994;114:669-74.
  • Laccourreye H, Laccourreye O, Weinstein G, Menard M, Brasnu D. Supracricoid laryngectomy with cri- cohyoidopexy: a partial laryngeal procedure for selected supraglottic and transglottic carcinomas. Laryngoscope 1990;100:735-41.
  • de Vincentiis M, Minni A, Gallo A. Supracricoid laryn- gectomy with cricohyoidopexy (CHP) in the treatment of laryngeal cancer: a functional and oncologic experi- ence. Laryngoscope 1996;106:1108-14.
  • Naudo P, Laccourreye O, Weinstein G, Jouffre V, Laccourreye H, Brasnu D. Complications and func- tional outcome after supracricoid partial laryngecto- my with cricohyoidoepiglottopexy. Otolaryngol Head Neck Surg 1998;118:124-9.
  • Bron L, Brossard E, Monnier P, Pasche P. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy and cricohyoidopexy for glottic and supraglottic carci- nomas. Laryngoscope 2000;110:627-34.
  • Tuncel U, Aygenc E, Yilmaz YF, Unal A. Ruptured pexy after supracricoid partial laryngectomy: a case report. KBB-Forum Electronic Journal of Otolaryngology – Head and Neck Surgery 2003;2. Available from: http:// kbb-forum.net/journal/text.php3?id=22.
  • Brasnu DF, Hartl DM, Laccourreye H. Supracricoid par- tial laryngectomy with cricohyoidopexy. In: Weinstein GS, editor. Organ preservation surgery for laryngeal can- cer. San Diego, CA: Singular Publishing; 1999. p. 127-48.
  • Naudo P, Laccourreye O, Weinstein G, Hans S, Laccourreye H, Brasnu D. Functional outcome and prognosis factors after supracricoid partial laryngecto- my with cricohyoidopexy. Ann Otol Rhinol Laryngol 1997;106:291-6.
  • Traissac L, Verhulst J. Technical indications and results of reconstructive laryngectomies. Rev Laryngol Otol Rhinol 1991;112:55-8. [Abstract]
  • Bely-Toueg N, Halimi P, Laccourreye O, Laskri F, Brasnu D, Frija G. Normal laryngeal CT findings after supracricoid partial laryngectomy. AJNR Am J Neuroradiol 2001;22:1872-80.
  • Maroldi R, Battaglia G, Nicolai P, Maculotti P, Cappiello J, Cabassa P, et al. CT appearance of the larynx after conservative and radical surgery for carcinomas. Eur Radiol 1997;7:418-31.
There are 12 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Fikret Kasapoğlu This is me

Levent Erişen This is me

Cüneyt Erdoğan This is me

Publication Date June 25, 2008
Published in Issue Year 2008 Volume: 18 Issue: 3

Cite

APA Kasapoğlu, F., Erişen, L., & Erdoğan, C. (2008). Suspicion of cricohyoidopexy line rupture after supracricoid partial laryngectomy and the value of computed tomography to exclude this complication. The Turkish Journal of Ear Nose and Throat, 18(3), 179-181.
AMA Kasapoğlu F, Erişen L, Erdoğan C. Suspicion of cricohyoidopexy line rupture after supracricoid partial laryngectomy and the value of computed tomography to exclude this complication. Tr-ENT. June 2008;18(3):179-181.
Chicago Kasapoğlu, Fikret, Levent Erişen, and Cüneyt Erdoğan. “Suspicion of Cricohyoidopexy Line Rupture After Supracricoid Partial Laryngectomy and the Value of Computed Tomography to Exclude This Complication”. The Turkish Journal of Ear Nose and Throat 18, no. 3 (June 2008): 179-81.
EndNote Kasapoğlu F, Erişen L, Erdoğan C (June 1, 2008) Suspicion of cricohyoidopexy line rupture after supracricoid partial laryngectomy and the value of computed tomography to exclude this complication. The Turkish Journal of Ear Nose and Throat 18 3 179–181.
IEEE F. Kasapoğlu, L. Erişen, and C. Erdoğan, “Suspicion of cricohyoidopexy line rupture after supracricoid partial laryngectomy and the value of computed tomography to exclude this complication”, Tr-ENT, vol. 18, no. 3, pp. 179–181, 2008.
ISNAD Kasapoğlu, Fikret et al. “Suspicion of Cricohyoidopexy Line Rupture After Supracricoid Partial Laryngectomy and the Value of Computed Tomography to Exclude This Complication”. The Turkish Journal of Ear Nose and Throat 18/3 (June 2008), 179-181.
JAMA Kasapoğlu F, Erişen L, Erdoğan C. Suspicion of cricohyoidopexy line rupture after supracricoid partial laryngectomy and the value of computed tomography to exclude this complication. Tr-ENT. 2008;18:179–181.
MLA Kasapoğlu, Fikret et al. “Suspicion of Cricohyoidopexy Line Rupture After Supracricoid Partial Laryngectomy and the Value of Computed Tomography to Exclude This Complication”. The Turkish Journal of Ear Nose and Throat, vol. 18, no. 3, 2008, pp. 179-81.
Vancouver Kasapoğlu F, Erişen L, Erdoğan C. Suspicion of cricohyoidopexy line rupture after supracricoid partial laryngectomy and the value of computed tomography to exclude this complication. Tr-ENT. 2008;18(3):179-81.