Cyanoacrylate in the repair of cervical pleural injury

Injury to the apical parietal pleura may occur in neck surgery, especially in cases of neck dissection or the removal of tumors from the thoracic inlet area. During pediatric tracheotomy the occurrence of this condition is sometimes inevitable, even in experienced hands. The close relationship of the root of the neck to the dome-shaped pleura, reaching 2-2.5 cm. above the medial part of the clavicle, creates an anatomical predisposition to the occurrence of iatrogenic pneumothorax. During assisted mechanical ventilation, the escape of air from the thorax with a characteristic whistle or with the appearance of bubbles on the pleural surface, makes the surgeon aware of this condition. Immediate repair of the pleural defect may prevent the accumulation of a sufficient volume of air between the visceral and parietal pleura, causing collapse of the lung.