Esophageal tear in a patient undergoing stereotactic brain biopsy under general anesthesia

Injuries of the esophagus with resultant mediastinitis have been reported following endotracheal intubation. Herein, we report a case of esophageal perforation that resulted from difficulty with intubation in a patient with a stereotactic head frame. A 52-year-old woman underwent a stereotactic brain biopsy of a left temporal tumor. After a stereotactic head frame was applied, intubation for anesthesia required three attempts. On postoperative day 2, she complained of worsening dysphagia and chest pain. A 4-mm tear in the right posterior cervical esophagus was discovered and repaired. Esophageal perforation may arise from limited neck extension imposed by a stereotactic head frame. Unexplained dysphagia postoperatively is the hallmark of this rare complication.