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Case Reports
. 2021 Aug 20;14(8):e244589.
doi: 10.1136/bcr-2021-244589.

Failure of OPHL type IIb due to undiagnosed Eagle syndrome

Barbara Verro  1 , Carmelo Saraniti  2
Affiliations
Case Reports

Failure of OPHL type IIb due to undiagnosed Eagle syndrome

Barbara Verro et al. BMJ Case Rep. .

Abstract

A 52-year-old man with glottic-supraglottic tumour underwent open partial horizontal laryngectomy (OPHL) IIb. On the 12th day postoperative, laryngoscopy showed necrotic tissue at the level of pexy and an increased distance between tongue base and neoglottis; the neck CT showed cricoid arch rupture and rupture of the pexy. By re-examining the preoperative CT images, the ossification of stylohyoid ligament (Eagle syndrome) was detected and supposed as the possible cause of cricoid rupture due to its traction on the hyoid bone and therefore on the pexy. The stylohyoid ligaments were cut at their insertion on the hyoid bone and a tracheohyoidopexy was performed. Two months after surgery, the patient had only some swallowing impairments. This case represents a complication in OPHL II never reported in literature caused by an undiagnosed Eagle syndrome in preoperative, pointing out the importance to search for any anatomical anomaly that could jeopardise the success of the surgery.

Keywords: cancer intervention; ear; head and neck cancer; head and neck surgery; nose and throat/otolaryngology; radiology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preoperative laryngoscopy of laryngeal lesion: ulcerated lesion involving the aryepiglottic fold (black arrow) and the false vocal cord (white arrow) and Reinke’s oedema of the ipsilateral true vocal cord (asterisk).
Figure 2
Figure 2
CT neck: (A) cricoid body (yellow arrow) without arch (red arrow); (B) ruptured cricoid arch (red arrow) and perylaryngeal emphysema (asterisk).
Figure 3
Figure 3
CT neck: elongated styloid process (red arrows).
Figure 4
Figure 4
Post-tracheohyoidopexy control at sixth months: (A) spared right arytenoid (black arrow) in abduction; (B) spared right arytenoid (black arrow) in adduction, tongue base (asterisk).
See this image and copyright information in PMC

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