Cervicofacial emphysema and pneumomediastinum complicating adenotonsillectomy

Main Article Content

A. G. Adekanye A. N. Umana A. O. Akintomide B. Nakanda R. B. Mgbe M. E. Offiong B. Asuquo

Abstract

Subcutaneous emphysema after adeno-tonsillectomy is rarely encountered. One of such cases following adenotonsilectomy was seen in our institution.

We report the case of a 5-year-old girl who developed cervicofacial emphysema and pneumomediastinum following retching and vomiting 6 hours after a routine adenotonsillectomy. Radiograph of the jaws and chest revealed subcutaneous emphysema. Previously published cases showed that the cause was most likely due to air passing into subcutaneous tissue through the tonsillar fossa and superior constrictor muscle into the facial layers of the neck following a bout of coughing and straining (crying), or the use of positive pressure ventilation. The emphysema can then spread to parapharyngeal and retropharyngeal spaces with associated morbidities. Further complications may include pneumothorax and pneumomediastinum and this should be excluded.

Article Details

How to Cite
ADEKANYE, A. G. et al. Cervicofacial emphysema and pneumomediastinum complicating adenotonsillectomy. Medical Research Archives, [S.l.], v. 5, n. 6, june 2017. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/1317>. Date accessed: 15 nov. 2024.
Keywords
subcutaneous emphysema; pneumo-mediastinum; adenotonsillectomy
Section
Case Reports

References

1. Erickson BK, Larson DR, St SavverJL, Meverden RA, Orvidas LJ, Changes in incidence and indications of tonsillectomy and adenoidectomy 1970-2005. Otolaryngol Head Neck Surg. 2009; 6(140): 894-901.
2. Van den Akker EH, Schilder AG, Kemps YJ, Van Balen FA, Hordjk GJ, Hoes AW, Current indications for (Adeno) tonsillectomy in children: A survey in the Netherlands. Int J Pediatr otorhinolaryngol. 2003; 6(67): 603- 607.
3. Bhattacharyya N, Lin HW, Changes and consistencies in the epidemiology of pediatric adenotonsillar surgery 1996-2006. Otolaryngol Head Neck surg. 2010; 5 (143): 680-684.
4. Amin R, Somers VK, McConnell K, Activity-adjusted 24-hour ambulatory blood pressure and cardiac remodeling in children with sleep disordered breathing. Hypertension. 2008;
1 (51): 84-91.
5. Gozal D, Capdevila OS, Kheirandish-Gozal L, Metabolic alterations and systemic inflammation in obstructive sleep apnea among nonobese and obese prepubertal children. Am J Respir Crit Care Med. 2008; 10 (177): 1142-1149.
6. Nafiu OO, Green GE, Walton S, Morris M, Reddy S, Tremper KK, Obesity and risk of perioperative complications in children presenting for adenotonsillectomy. Int JPediatr Otorhinolaryngol.vol. 2009; 1 (73): 89-95.
7. Hung MH, Shin PY, Yang YM, Lan JY, Fan SZ, and Jeng CS, Cervicofacial subcutaneous emphysema following tonsillectomy: implications for anaesthesiologists. Acta Anaesthesiologica Taiwanica. , 2009; 3 (47): 134-137.
8. Miman MC, Oztuan O, Durmus M, Kalcioglu MT, Gedik E, Cervical subcutaneous emphysema: an unusual complication of adenotonsillectomy. Paediatr. Anaesthisol. 200; (11): 491-493.
9. Jiang RS, Mora R, Cervicofacial surgical 
emphysema following tonsillectomy: a case report. Hindawi Publishing Corporation. 2014; (2014): 2.
10. Yammine NV, Alherabi A, Gerin-Lajoie J, Post- tonsillectomy subcutaneous emphysema and pneumomediastinum. J Otolaryngol