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CASE REPORT
Year : 2013  |  Volume : 57  |  Issue : 3  |  Page : 285-288

Laryngeal dislocation after ventral fusion of the cervical spine


1 Department of Anesthesiology and Intensive Care, University Medical Center of Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany
2 Department of Neurosurgery, University Medical Center of Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany
3 Department of Ears, Nose, Throat, University Medical Center of Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany

Correspondence Address:
Sascha Tank
Department of Anesthesiology and Intensive Care, Hamburg-Eppendorf University Hospital, Martinistrasse 52, 20246 Hamburg
Germany
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.115615

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We report on a 70-year-old patient who underwent ventral fusion of the cervical spine (C3/4 and C4/5) for spinal canal stenosis performed by the neurosurgery department. The patient suffered an exceedingly rare complication of the surgery - laryngeal dislocation. Had the deformed laryngeal structures been overlooked and the patient extubated as usual after surgery, reintubation would have been impossible due to the associated swelling, which might have had disastrous consequences. Leftward dislocation of the larynx became apparent post-operatively, but prior to extubation. Extubation was therefore postponed and a subsequent computed tomography (CT) scan revealed entrapment of laryngeal structures within the osteosynthesis. A trial of repositioning using microlaryngoscopy performed by otolaryngology (ears, nose and throat) specialists failed, making open surgical revision necessary. At surgery, the entrapped laryngeal tissue was successfully mobilised. Laryngeal oedema developed despite prompt repositioning; thus, necessitating tracheotomy and long-term ventilation. Laryngeal dislocation may be an unusual cause of post-operative neck swelling after anterior cervical spine surgery and should be considered in the differential diagnosis if surgical site haematoma and other causes have been ruled out. Imaging studies including CT of the neck may be needed before extubation to confirm the suspicion and should be promptly obtained to facilitate specific treatment.


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