Management of Acquired Tracheoesophageal Fistula and Complete Pharyngoesophageal Stenosis as a Complication of COVID-19 - Abstract
Background: Many patients experiencing severe symptoms of COVID-19 require critical care involving intubation, tracheostomy, and mechanical ventilation. These treatment interventions can result in life-threatening consequences. Methods: We report a case demonstrating severe complications of COVID-19 and prolonged intubation. This patient developed a tracheoesophageal fistula (TEF) and complete pharyngoesophageal stenosis (PES). We detail the novel operative repair of this complex injury and review the literature regarding iatrogenic airway-injuries experienced by COVID-19 patients after prolonged intubation and mechanical ventilation. Results: Following a year of G-tube dependence and unsuccessful attempts at repair, our patient underwent successful surgical reconstruction via tracheal resection and esophageal reconstruction with a radial forearm free flap. Two months post-operatively, the patient has a stable airway and maintains his weight by oral nutrition. Conclusions: Head and neck surgeons must be well-versed in techniques for upper aerodigestive restoration amidst this unprecedented rise in intubation-related injuries associated with the COVID-19 pandemic.