Facial Subcutaneous Emphysema As A Rare Complication Of Tonsillectomy

Abstract

Tonsillectomy is a very common procedure in Otolaryngology practice. Common complications include bleeding, which can be primary or secondary due to infection of the tonsillar bed. Subcutaneous emphysema after a tonsillectomy is very rare. We report a 19-year-old girl who developed cervicofacial subcutaneous emphysema several hours after tonsillectomy with successful conservative treatment outcome.

The Rare Occurrence of Post-tonsillectomy Surgical Emphysema

“…The treatment of subcutaneous emphysema varies according to its severity. Some cases resolve with observation alone [ 9 , 14 , 15 ]. However, associated infection, respiratory distress or severe pain necessitate hospitalization and oral restrictions.…”

“…However, associated infection, respiratory distress or severe pain necessitate hospitalization and oral restrictions. A regular assessment of the extent of emphysema and airway is needed [ 12 , 15 ]. Broad-spectrum antibiotics may also be prescribed [ 9 , 11 , 14 ].…”

“…Caution must be taken to treat pharyngeal and tonsillar mucosal damage [ 9 , 12 , 13 ]. The injured mucosa may be sutured to prevent secondary entrance of bacteria and to limit the extension of surgical emphysema [ 11 , 14 , 15 ]. A cold compress can be applied to the site of the swelling.…”

“…Activities that should be avoided include straining, vomiting and coughing as they increase upper airway pressure [ 8 , 10 , 11 , 14 , 15 ].…”

“…A cold compress can be applied to the site of the swelling. Moreover, if a patient is suffering from respiratory distress, 100% O2 should be administered [9,[12][13][14][15]. The treating physician should anticipate tracheostomy at any moment in case severe progressive emphysema results in airway obstruction [9,13,14].…”