Application of longus colli muscle flap in the repair of pyriform sinus perforation

Abstract

To investigate the result of repair of pyriform sinus perforation using longus colli muscle flap and to provide a new material of esophageal perforation repair. A retrospective clinical analysis was conducted on eight cases with pyriform sinus perforation from 2003-2013. Of the patients, 5 were males and 3 females, aged 45 to 68 years with a median age of 51 years. The causes included the esophagoscopy surgery (5 cases), anesthesia intubation (2 cases) and one case of swallowing foreign body. The duration were from seven days to 8 months, with a median duration of one month. All patients were associated with significant neck pain and swallowing pain. The complications were happened in all cases, including high fever in 5 cases, subcutaneous emphysema or mediastinal emphysema in 5 cases , and mediastinal abscess in 3 cases. The longus colli muscle flap was used to repair the perforation. The success rate of surgical repair was 100% in all 8 cases. No recurrence or esophageal stricture occured during the follow-up of six months to 10 years. Three cases complicated by mediastinal abscess and 1 case by piriform sinus-mediastinum -pleural fistula, which cured after combined treatment. Traumatic pyriform sinus perforation may cause serious complications. Early surgical repair is needed. The longus colli muscle flap is an ideal material for the repair of pyriform sinus perforation.