Rhinolalia: an underappreciated sign of pneumomediastinum

Thoracic surgeons are involved in the diagnosis and management of patients with mediastinal emphysema because of the potentially life-threatening conditions that either must be treated emergently or excluded. Although the classic findings of pneumomediastinum have been described for nearly 60 years, an underappreciated finding is the presence of rhinolalia. Case reports of this finding are sporadic and absent from the thoracic surgical literature. The presence of rhinolalia in association with spontaneous pneumomediastinum is highlighted in the following case presentation and prior reports are reviewed.