gms | German Medical Science

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.