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Updated: Jun 20, 2026
05:07
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Cervicofacial subcutaneous emphysema following tonsillectomy: implications for anesthesiologists
Ming-Hui Hung1, Po-Yuan Shih, Ya-Min Yang
1Department of Anesthesiology, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan, R.O.C.
Summary
Cervicofacial subcutaneous emphysema is a rare complication after tonsillectomy. This case highlights how coughing and positive pressure ventilation can cause it, but conservative treatment led to resolution.
Area of Science:
- Otolaryngology
- Surgical Complications
- Respiratory Medicine
Background:
- Tonsillectomy is a common surgical procedure.
- Cervicofacial subcutaneous emphysema is an uncommon complication post-tonsillectomy.
- Positive pressure ventilation and Valsalva maneuvers can contribute to emphysema development.
Purpose of the Study:
- To report a case of cervicofacial subcutaneous emphysema following tonsillectomy.
- To discuss potential causative factors and management strategies.
- To emphasize awareness of this rare complication.
Main Methods:
- Case presentation of a 37-year-old male patient.
- Identification of contributing factors: Valsalva maneuvers (coughing, straining) and positive pressure ventilation for laryngospasm.
- Conservative management including re-intubation, antibiotics, and cessation of enteral intake.
Main Results:
- Immediate development of cervicofacial subcutaneous emphysema post-extubation.
- Resolution of emphysema within 7 days with conservative treatment.
- Prevention of pneumomediastinum and pneumothorax through re-intubation.
Conclusions:
- Cervicofacial subcutaneous emphysema can occur unexpectedly after tonsillectomy.
- Valsalva maneuvers and positive pressure ventilation are potential contributing factors.
- Conservative management is effective, and preventative strategies should be considered.
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