Cervical osteomyelitis: A new identity of dreaded complication following pharyngeal cancer treatment
Background: Cervical osteomyelitis following the treatment of pharyngeal cancer with laryngectomy and chemoradiotherapy is poorly reported. Methods: Six cases of cervical osteomyelitis occurring over a 1-year period are described herein. These are reviewed alongside four cases reported previously in...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-03-01
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| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971219300177 |
| _version_ | 1818135075961700352 |
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| author | Emmanuel Zamparini Piseth Seng Matthieu Bardou Nicolas Fakhry Thomas Graillon Stéphane Fuentes Patrick Dessi Andreas Stein |
| author_facet | Emmanuel Zamparini Piseth Seng Matthieu Bardou Nicolas Fakhry Thomas Graillon Stéphane Fuentes Patrick Dessi Andreas Stein |
| author_sort | Emmanuel Zamparini |
| collection | DOAJ |
| description | Background: Cervical osteomyelitis following the treatment of pharyngeal cancer with laryngectomy and chemoradiotherapy is poorly reported. Methods: Six cases of cervical osteomyelitis occurring over a 1-year period are described herein. These are reviewed alongside four cases reported previously in the literature. Results: Among the total 10 cases, the average age of the patients was 58.7 years. The period between laryngectomy and the diagnosis of cervical osteomyelitis was on average 3 years and 1 month and the male to female sex ratio was 9:1. Two patients had a history of cervical fistula with an esophageal prosthesis, one had a spontaneous cervical fistula, one had a pharyngeal cutaneous fistula, and one had an esophageal prosthesis without any fistula. At the time of diagnosis, seven had a history of cervical pain (70%) and nine had a neurological deficit (90%). Seven patients (70%) underwent surgery; one (10%) was contraindicated for a general anesthetic and two (20%) died before any intervention. The indication for surgery was a neurological deficit for six patients (60%) and the requirement for lavage and debridement for two patients (20%). The average length of antimicrobial treatment was 12.7 weeks. The outcome was favorable for six patients. Four patients died. Conclusions: Cervical osteomyelitis is a serious but rarely reported complication following the treatment of pharyngeal cancer with chemoradiotherapy and laryngectomy. Cervical pain was the first sign to appear, sometimes 1 year before any other sign. Physicians should be aware of this dreaded complication, which is probably underdiagnosed and is related to an increased mortality rate. Keywords: Cervical osteomyelitis, Laryngectomy, Larynx carcinoma, Cervical cancer, Infection |
| first_indexed | 2024-12-11T09:18:45Z |
| format | Article |
| id | doaj.art-a111194f224247548a78546be99bcb9d |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-11T09:18:45Z |
| publishDate | 2019-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-a111194f224247548a78546be99bcb9d2022-12-22T01:13:18ZengElsevierInternational Journal of Infectious Diseases1201-97122019-03-0180118121Cervical osteomyelitis: A new identity of dreaded complication following pharyngeal cancer treatmentEmmanuel Zamparini0Piseth Seng1Matthieu Bardou2Nicolas Fakhry3Thomas Graillon4Stéphane Fuentes5Patrick Dessi6Andreas Stein7Service de Maladies Infectieuses Tropicales et Infections Chroniques (MITIC), IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; Centre de Référence des Infections Ostéo-Articulaires (CRIOA) Sud-Méditerranée, IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, FranceService de Maladies Infectieuses Tropicales et Infections Chroniques (MITIC), IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; Centre de Référence des Infections Ostéo-Articulaires (CRIOA) Sud-Méditerranée, IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), UM63, CNRS 7278, IRD 198, INSERM 1095, IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; Corresponding author at: Centre de Référence des Infections Ostéo-Articulaires (CRIOA) Sud-Méditerranée, Service de Maladies Infectieuses Tropicales et Infections Chroniques (MITIC), IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France.Service de Maladies Infectieuses Tropicales et Infections Chroniques (MITIC), IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; Centre de Référence des Infections Ostéo-Articulaires (CRIOA) Sud-Méditerranée, IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), UM63, CNRS 7278, IRD 198, INSERM 1095, IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, FranceService d’ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, APHM, Aix-Marseille Université, 13005, Marseille, FranceService de Neurochirurgie, Centre Hospitalier Universitaire La Timone, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, FranceService de Neurochirurgie, Centre Hospitalier Universitaire La Timone, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, FranceService d’ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, APHM, Aix-Marseille Université, 13005, Marseille, FranceService de Maladies Infectieuses Tropicales et Infections Chroniques (MITIC), IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; Centre de Référence des Infections Ostéo-Articulaires (CRIOA) Sud-Méditerranée, IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), UM63, CNRS 7278, IRD 198, INSERM 1095, IHU–Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, FranceBackground: Cervical osteomyelitis following the treatment of pharyngeal cancer with laryngectomy and chemoradiotherapy is poorly reported. Methods: Six cases of cervical osteomyelitis occurring over a 1-year period are described herein. These are reviewed alongside four cases reported previously in the literature. Results: Among the total 10 cases, the average age of the patients was 58.7 years. The period between laryngectomy and the diagnosis of cervical osteomyelitis was on average 3 years and 1 month and the male to female sex ratio was 9:1. Two patients had a history of cervical fistula with an esophageal prosthesis, one had a spontaneous cervical fistula, one had a pharyngeal cutaneous fistula, and one had an esophageal prosthesis without any fistula. At the time of diagnosis, seven had a history of cervical pain (70%) and nine had a neurological deficit (90%). Seven patients (70%) underwent surgery; one (10%) was contraindicated for a general anesthetic and two (20%) died before any intervention. The indication for surgery was a neurological deficit for six patients (60%) and the requirement for lavage and debridement for two patients (20%). The average length of antimicrobial treatment was 12.7 weeks. The outcome was favorable for six patients. Four patients died. Conclusions: Cervical osteomyelitis is a serious but rarely reported complication following the treatment of pharyngeal cancer with chemoradiotherapy and laryngectomy. Cervical pain was the first sign to appear, sometimes 1 year before any other sign. Physicians should be aware of this dreaded complication, which is probably underdiagnosed and is related to an increased mortality rate. Keywords: Cervical osteomyelitis, Laryngectomy, Larynx carcinoma, Cervical cancer, Infectionhttp://www.sciencedirect.com/science/article/pii/S1201971219300177 |
| spellingShingle | Emmanuel Zamparini Piseth Seng Matthieu Bardou Nicolas Fakhry Thomas Graillon Stéphane Fuentes Patrick Dessi Andreas Stein Cervical osteomyelitis: A new identity of dreaded complication following pharyngeal cancer treatment International Journal of Infectious Diseases |
| title | Cervical osteomyelitis: A new identity of dreaded complication following pharyngeal cancer treatment |
| title_full | Cervical osteomyelitis: A new identity of dreaded complication following pharyngeal cancer treatment |
| title_fullStr | Cervical osteomyelitis: A new identity of dreaded complication following pharyngeal cancer treatment |
| title_full_unstemmed | Cervical osteomyelitis: A new identity of dreaded complication following pharyngeal cancer treatment |
| title_short | Cervical osteomyelitis: A new identity of dreaded complication following pharyngeal cancer treatment |
| title_sort | cervical osteomyelitis a new identity of dreaded complication following pharyngeal cancer treatment |
| url | http://www.sciencedirect.com/science/article/pii/S1201971219300177 |
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