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Updated: Jun 15, 2026
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
[Mediastinal emphysema as a complication of the tonsilloadenotomy in child]
Sławomir Piotrowski1, Dominika Jesikiewicz
1Oddział Otolaryngologiczny Szpitala Miejskiego im. Brudzińskiego w Gdyni. spiotrowski@wp.pl
Insights
Mediastinal emphysema is a rare complication following tonsilloadenotomy. Prompt diagnosis and surgical intervention, including mediastinal drainage, are crucial for successful treatment in pediatric patients.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Thoracic Surgery
Background:
- Tonsilloadenotomy is a common procedure in pediatric otolaryngology.
- Potential complications, though rare, require thorough understanding and management.
- Mediastinal emphysema is an uncommon but serious post-tonsillectomy complication.
Observation:
- A 6-year-old boy developed mediastinal emphysema after tonsilloadenotomy.
- The complication was linked to potential pharyngeal wall injury during surgery, possibly exacerbated by post-anesthesia vomiting.
- The patient required intensive care, including prolonged intubation and parenteral feeding.
Findings:
- Surgical management involved upper mediastinotomy with mediastinal drainage.
- The child recovered fully within 14 days of treatment.
- The case highlights the importance of meticulous post-operative care for early detection.
Implications:
- Emphasizes the need for vigilance regarding rare complications of tonsilloadenotomy.
- Suggests a re-evaluation of the risks associated with tonsil surgery, particularly in pediatric cases.
- Underscores the critical role of prompt diagnosis and intervention in managing mediastinal emphysema.
Aim Of The Paper:
Authors present the case of a 6 years old boy with rare complication of mediastinal emphysema after tonsilloadenotomy.
Material And Methods:
Authors detailed describe the evolution of this complication and methods of its treatment. This complication was treated in Child's Surgery Clinic where the digestive and respiratory tracts were controlled and upper mediastinotomy with drainage of the mediastinum was performed. Subsequently, the child was treated on the Intensive Care Unit where prolonged intubation and parenteral feeding were used and was discharged completely healed after 7 days. Authors discuss possible causes of this complication as a result of injury of the pharyngeal wall during the operation due to vomits after general anastesia. RESULTS OF THE TREATMENT: Total period of treatment of this complication was 14 days. The authors deal as well with the issue of underestimating the risk associated with the operational procedures on tonsils, especially in the case of children. They also consider the possibility of performing such procedures in the one day surgery conditions.
Conclusions:
The analysed complication associated with tonsils operation are rather unusual and its successfull treatment depends on quick and accurate diagnosis, which is possible due to meticulous postoperational care.
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