Surgical Emphysema in a Pediatric Tertiary Referral Center

Area of Science:

• Pediatric Otolaryngology
• Trauma Surgery
• Emergency Medicine

Background:

• Laryngeal trauma is rare in children but poses significant risks due to the smaller pediatric larynx.
• Surgical emphysema is a common, potentially life-threatening complication of pediatric laryngeal trauma.

Observation:

• Two pediatric cases of laryngeal trauma with extensive surgical emphysema are presented.
• Case 1 involved airway compromise and respiratory arrest, managed with chest drains, intubation, and tracheostomy.
• Case 2 presented with widespread surgical emphysema in a stable child and was managed conservatively.

Findings:

• Surgical emphysema can rapidly lead to patient deterioration and may impede ultrasound diagnostics.
• Prompt airway securing via intubation or tracheostomy is vital if airway patency is a concern.
• Stable pediatric patients without laryngeal edema can be managed conservatively with close monitoring.

Implications:

• Timely intervention for airway compromise in pediatric laryngeal trauma is critical for favorable outcomes.
• Conservative management is viable for stable pediatric patients with surgical emphysema and no laryngeal edema.
• Close monitoring in high-dependency units is essential for pediatric patients with laryngeal trauma and surgical emphysema.