This report presents a case of esophageal fistula with recurrent cervical abscess as the initial symptom. The patient underwent anterior cervical fracture reduction and internal fixation in 2021 due to trauma. In 2023, the patient received radiofrequency ablation for bilateral thyroid lobe lesions, after which recurrent cervical abscesses occurred over an 8-month period. Fiberoptic laryngoscopy with the biopsy channel insufflation method revealed a large esophageal fistula at the esophageal inlet. After removing the internal fixation plate, the patient received daily wound care, and serial fiberoptic laryngoscopy revealed spontaneous healing of the esophageal fistula. During the 1-year follow-up, no recurrence of cervical abscess was observed, and the esophageal fistula healed well.
Humans ; Abscess ; Recurrence ; Neck ; Female ; Adult ; Fracture Fixation, Internal

Objective:To evaluate the accuracy and safety profile of a novel cuboid orientation-guided frontal horn ventriculostomy technique in patients with large hemispheric infarction (LHI).Methods:It was conducted a retrospective cohort study of 48 consecutive LHI patients who underwent the innovative ventriculostomy procedure between time period. Primary outcomes included procedural accuracy (success rates, catheter positioning) and safety indicators (complication rates).Results:All the punctured ventricles were small or of normal size. The success rate of puncture was 100%, the success rate of one-time puncture was 87% (42/48), and the average number of puncture was 1.13 times per case. The ratio of well-positioned tube heads was 87.5% (42/48). The actual angle of the inward deviation of the puncture ranged from -2o to 5o, with an average of 0o±0.3o. The depth of puncture was 7.0-8.0 cm ( 7.3±0.3) cm. The incidence of bleeding around the puncture path was 1.3% (2/48 ) and no massive bleeding occurred. At the 6-month follow-up, one case (2.94%) among the 34 survivors had epilepsy.Conclusions:The cuboid orientation-guided frontal horn ventriculostomy technique demonstrates exceptional procedural accuracy and an excellent safety profile in LHI patients, with high first-pass success rates (87.5%) and minimal complications (4.2% minor hemorrhage). These findings support its clinical adoption for this patient population.

Objective:To explore the effect and safety of stereotactic aspiration of necrotic brain tissue for the patients≥61 years with malignant middle cerebral artery infarction (MMI).Methods:A total of 102 MMI patients aged≥61 years were enrolled retrospectively. All patients were subject to conservative medical treatment alone or in addition to stereotactic aspiration of necrotic brain tissue 24-72 hours after symptom onset. Perioperative outcomes and 6-month follow-up outcomes were observed and evaluated.Results:Baseline data characteristics were well balanced between the conservative treat group and aspiration group, except for the prevalence of hypertension. The incidence of early cerebral herniation (9.1% vs. 48.3%, χ2=17.843, P<0.001) and death (13.6% vs. 60.3%, χ2=22.707, P<0.001)in the aspiration group was significantly lower than that in the conservative group, and there was no significant difference in the incidence of cerebral hemorrhage ( P=0.726) and intracranial infection ( P=0.186) between the groups. At 6-month follow-up, compared with the conservative treatment group, the aspiration group had a higher proportion of favorable outcome (mRS 0-3) (38.6% vs. 3.4%, χ2 =20.438, P<0.001) and survival without severe disability (mRS 0-4) (68.2% vs. 22.4%, χ2=21.492, P<0.001). Comparison of clinical characteristics of favorable outcome (mRS 0-3) group and unfavorable (mRS 4-6) group showed that the proportion of patients treated with aspiration was significantly higher than that treated with medical therapy alone (89.5% vs. 10.5%, P<0.001). Multivariate logisitic regression used to adjust the confound factors such as atrial fibrillation, diabetes and smoking, the GCS and the NIHSS score of 24 hours after onset, etc, revealed that the treatment with aspiration was an independent association factor for the ratio of 6-month favorable outcome for the elderly patients with MMI ( OR=126.704, 95% CI: 7.236-2218.610, P<0.001). Conclusions:The stereotactic aspiration of necrotic brain tissue are effective and safe for the elderly patients with MMI.

Objective: To investigate the efficacy and safety of cuboid stereotactic aspiration of necrotic brain tissue for treating malignant middle cerebral artery infarction in the elderly patients. Methods: Sixteen elderly patients with malignant middle cerebral artery infarction were selected from June 2017 to January 2019 in our hospital. Patients were followed up for 6 months to evaluate the efficacy of stereotactic aspiration of necrotic brain tissue using the modified Rankin Scale (mRS). Results: The 30-day mortality was 18.75%. Among the 16 elderly patients, 6 (37.5%) had an mRS score of 3 (defined as moderate disability), 6 (37.5%) had an mRS score of 4 (defined as moderate to severe disability), 1 (6.25%) had an mRS score of 5 (defined as severe disability), and 3 (18.75%) had an mRS score of 6. The probability of 6-month favorable outcome, defined as an mRS score of ≤3, was 37.5%, and the 6-month mortality was 18.75%. Conclusions It is a simple, minimally invasive, effective and safe method to treat malignant middle cerebral artery infarction in the elderly patients with cuboid stereotactic aspiration of necrotic brain tissue, which needs to be confirmed by further randomized controlled studies.