Shut and open

Question: A 44 year old woman undergoes transcervical Zenker’s diverticulum repair. Postoperatively, the patient does well and goes home after 24 hours of observation. One week later, the patient reports neck swelling, pain, and dysphagia suggestive of a salivary fistula. What is the best approach to management?

a) Open the wound and make the patient NPO

b) Flexible esophagoscopy

c) MRI of the neck to evaluate soft tissue infection

d) Pectoralis flap reconstruction

[Answer will be posted with next week's new question]

Answer to last week's question, “Bad Connection” (October 24, 2023)

B - Oroantral fistula.