Onset of subcutaneous emphysema and pneumomediastinum after tonsillectomy: a case report

Abstract

Several complications can be related to surgical approaches of head and neck regions. Among those, there are rare conditions such as pneumomediastinum, pneumothorax and subcutaneous cervical emphysema. This study reports a case of a patient that developed pneumomediastinum, pneumothorax and subcutaneous emphysema after undergoing tonsillectomy. In order to reduce these complications in surgical approaches such as tonsillectomy, care should be taken with intubation, use of oxygen mask for positive pressure ventilation during anesthesia recovery, aggressive surgical maneuvers and use of surgical instruments that may cause deep tonsillar injuries.

Late presentation of subcutaneous emphysema and pneumomediastinum following elective tonsillectomy

“…When both conditions occur together, the order in which the symptoms present helps to identify the site of injury. Most patients with defects involving the tonsillar fossae presented acutely with facial and/or neck swelling [6]. Air may subsequently track caudally to the mediastinum, with the development of dyspnea, dysphagia, chest and back pain, and possible respiratory distress.…”

Subcutaneous Emphysema, Pneumo-Orbita and Pneumomediastinum Following a Facial Trauma Caused by a High-Pressure Car Washer

“…[1,[10][11][12][13][14] Pneumomediastinum following cervicofacial emphysema is very rare and has been reported after orofacial trauma, head and neck surgery, or dental surgical procedures. [11][12][13][14][15][16] Orbital trauma leading to periorbital subcutaneous emphysema extending to neck and mediastinum is a very rare occurrence. [17] During isolated facial trauma, air may be forcefully introduced into the parapharyngeal and retropharyngeal spaces, follow the potential space at the prevertebral and fascial planes, and can lead to emphysema in the neck and mediastinum.…”

Subcutaneous Emphysema Secondary to Tonsillectomy

“…7,10 In most cases, the emphysema resolved spontaneously. Only three cases required aggressive treatment-one case required a tracheotomy 10 and two cases involved a thoracotomy.…”