gms | German Medical Science

GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNOKHC)

ISSN 1865-1038

Necrotizing fasciitis of the neck after total laryngectomy and primary insertion of voice prosthesis: two case reports


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  • corresponding author Ana Danic Hadzibegovic - General Hospital "Dr. Josip Bencevic", Slavonski Brod, Croatia
  • Davorin Danic - General Hospital "Dr. Josip Bencevic", Slavonski Brod, Croatia

GMS Curr Posters Otorhinolaryngol Head Neck Surg 2010;6:Doc83

doi: 10.3205/cpo000576, urn:nbn:de:0183-cpo0005762

Published: April 22, 2010

© 2010 Danic Hadzibegovic et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Necrotizing fasciitis (NF) is an unusual, life threatening, rapidly advancing infection characterized by wide spread fascial and subcutaneous tissue necrosis with gangrene of the skin. It most commonly affects the extremities, abdominal wall and perineum whereas cervical NF is rare. NF of head and neck is often caused by both aerobic and anaerobic microorganisms found in upper aerodigestive tract. Usually, cervical NF originates from odontogenic, tonsillar and pharyngeal infection, and it is very rarely a complication of surgical procedure. Without immediate surgical treatment cervical NF leads to mediastinitis and fatal sepsis. There is only one case of cervical NF after total laryngectomy described in literature. We report two cases of cervical NF after total laryngectomy, selective neck dissection and primary vocal prosthesis insertion. In both cases infection spread to thoracic region and in one of them NF was associated with Lemierre’s syndrome, thrombosis of internal jugular vein. During the infection in both patients vocal prosthesis was inserted and did not influence the healing process.