期刊
YONAGO ACTA MEDICA
卷 62, 期 3, 页码 253-257出版社
TOTTORI UNIV MEDICAL PRESS
DOI: 10.33160/yam.2019.09.002
关键词
cricopharyngeal myotomy; deep neck abscess; descending necrotizing mediastinitis; dysphagia; laryngeal elevation; surgical treatment
Descending necrotizing mediastinitis (DNM) is a life-threatening disease with a high fatality rate that occurs as a complication of deep neck abscess. DNM complicated by severe dysphagia during the postoperative period has been previously reported, but there have been no published cases of surgical treatment for severe dysphagia secondary to DNM. A 63-year-old man was diagnosed with a deep neck abscess followed by DNM. The patient had dysphagia after incision and drainage of the abscess and drainage for DNM with video-assisted thoracic surgery (VATS). A comprehensive long-term physiotherapy program with a speech and language therapist did not reduce his dysphagia. Thus, the patient underwent laryngeal elevation and cricopharyngeal myotomy, which enabled oral intake. Surgery should be considered for prolonged severe restriction of laryngeal elevation and esophageal introitus opening that is unresponsive to physiotherapy with a speech and language therapist.
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