Our Summary

Cervical necrotizing fasciitis (CNF) is a rare but very serious infection that can cause severe damage in the neck region of the body. It often affects adults who have other health conditions and is usually caused by multiple types of bacteria. The main problem it causes is tissue death, or necrosis. This study reports on a case where a child experienced CNF along with a sudden, severe drop in blood pressure (shock) after having surgery (a Sistrunk procedure) to remove a suspected thyroglossal duct cyst. This is a rare complication that surgeons need to be aware of. Even though most instances of CNF are caused by dental infections and involve multiple types of bacteria, other sources of the disease are possible. It’s crucial for surgeons who treat children to quickly identify CNF and shock in order to start treatment as soon as possible, as this greatly increases the chances of the patient surviving.

FAQs

  1. What is cervical necrotizing fasciitis (CNF)?
  2. How is CNF typically caused and who does it often affect?
  3. What is the significance of the reported case of a child experiencing CNF after a Sistrunk procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thyroglossal duct cyst removal is to closely monitor the surgical site for any signs of infection, such as increased redness, swelling, or drainage. It’s important to promptly report any concerning symptoms to your healthcare provider in order to prevent complications like cervical necrotizing fasciitis. Additionally, following post-operative care instructions, such as keeping the area clean and dry, can help reduce the risk of infection and promote healing.

Suitable For

Patients who are typically recommended for thyroglossal duct cyst removal include those who have recurrent infections or abscesses in the cyst, difficulty swallowing or breathing due to the cyst pressing on the airway or esophagus, and cosmetic concerns about the appearance of a visible lump in the neck. In some cases, a thyroglossal duct cyst may also be removed if there is concern about the development of thyroid cancer within the cyst.

Timeline

  • Patient discovers a lump in the neck and seeks medical attention
  • Doctor diagnoses the lump as a thyroglossal duct cyst and recommends surgical removal
  • Patient undergoes a Sistrunk procedure to remove the cyst
  • Patient experiences sudden, severe drop in blood pressure and is diagnosed with cervical necrotizing fasciitis
  • Patient is treated with antibiotics, surgery to remove infected tissue, and supportive care
  • Patient recovers from the infection and undergoes follow-up appointments to monitor recovery and any potential complications

What to Ask Your Doctor

  1. What are the risks and potential complications associated with thyroglossal duct cyst removal surgery?
  2. How common is cervical necrotizing fasciitis (CNF) as a complication of this surgery?
  3. What symptoms should I watch for that may indicate CNF or other complications after surgery?
  4. How will you monitor me for signs of infection or other issues after the surgery?
  5. What steps will be taken to minimize the risk of CNF or other complications during and after surgery?
  6. What is the typical recovery process like after thyroglossal duct cyst removal surgery?
  7. Are there any specific warning signs that should prompt me to seek immediate medical attention after the surgery?
  8. How experienced are you in performing this type of surgery, and what is your success rate in preventing complications like CNF?
  9. Are there any alternative treatment options that may be safer for me given my individual health history?
  10. How long will I be in the hospital after the surgery, and what follow-up care will be necessary?

Reference

Authors: Hankey PB, Brown JR. Journal: Ear Nose Throat J. 2025 Mar;104(1_suppl):267S-270S. doi: 10.1177/01455613221139404. Epub 2022 Nov 10. PMID: 36356106