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Case Reports
Cerebrospinal fluid leak after anterior cervical disc fusion: an unusual cause of dysphagia and neck mass.
- Madeleine R Schaberg, Jason I Altman, Stanley M Shapshay, and Peak Woo.
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai School of Medicine, New York, NY 10029, USA. madeleine.schaberg@gmail.com
- Laryngoscope. 2007 Nov 1;117(11):1899-901.
ObjectiveDysphagia after anterior cervical disc fusion (ACDF) is a common complaint. We present two cases of dysphagia caused by a rare complication after ACDF: cerebrospinal fluid (CSF) leak into the neck.Study DesignA case series of two patients.MethodsBoth patients underwent a chart review, comprehensive history, physical examination, flexible nasolaryngoscopy, and radiographic imaging. A literature review of the MEDLINE database (1966-2006), using key words "dysphagia" and "anterior discectomy," was performed.ResultsWe present two patients with persistent dysphagia after ACDF surgery caused by CSF leak into the neck. Their clinical presentation, physical and radiographic examination findings, and hospital course will be discussed.ConclusionsCSF collection presenting as dysphagia and neck mass after ACDF must be included in the differential diagnosis because incision and drainage is contraindicated, and fine needle aspiration (FNA) must be performed under sterile conditions. Treatment including lumbar drain or re-exploration is appropriate.
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