Epidural abscess and paraplegia: Delayed sequela of tracheoesophageal puncture

We report the case of a patient who developed an epidural abscess several months following primary TEP. Tracheoesophageal puncture (TEP) is a common procedure used for speech rehabilitation in total laryngectomy (TL) patients. Epidural abscess after TEP placement is a rare complication but there are several cases reported in the literature. Patients typically present with neck pain and/or dysphagia, in addition to signs and symptoms of infection. Her case was unusual in that she presented initially with paraplegia without neck pain or dysphagia. Surgical evacuation of the abscess was performed urgently, however the patient developed osteomyelitis of the cervical spine with persistent cord compression and irreversible paraplegia. She subsequently expired from sepsis. Epidural abscess after TEP placement is a serious but rare complication. Early detection and treatment are imperative to avoid poor long-term outcomes.