An unusual complication of panendoscopy of the upper aero-digestive tract: esophageal perforation. A report of 3 cases.
Tombu S. Moreau P. Honore P.
Department ENT, Head and Neck Surgery, CHU Liege, Belgium.
Three cases of iatrogenic esophageal perforation are presented from a series of 1275 panendoscopies of the upper aero-digestive tract utilising rigid esophoscopy (0.24%). In all cases, the diagnosis was made during the endoscopy permitting immediate surgical treatment under the same anesthesia, via thoracoscopy or laparoscopy in two cases and by means of thoracotomy in the remaining case. The perforation was localised at the level of the inferior third of the esophagus in all three cases. In spite of the early intervention, there was one mortality in a patient whose pre-existing fibrothorax created a hazardous terrain.
Vocal cord immobilisation in diffuse idiopathic skeletal hyperostosis (DISH).
Verstraete WL. De Cauwer HG. Verhulst D. Jacobs F.
Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp, Belgium.
Advanced forms of diffuse idiopathic skeletal hyperostosis or Forestier's disease can induce dysphagia and significant respiratory symptoms such as hoarseness, dyspnea, snoring and laryngeal stridor. Severe respiratory distress is very rare. Two identical cases of chronic respiratory distress due to bilateral vocal cord adduction-fixation in conjunction with skeletal pathology in the cervical area are presented. The clinical, diagnostic and therapeutic work-up and the prognostic outcome of the laryngeal pathology are discussed.