The Rare Occurrence of Post-tonsillectomy Surgical Emphysema

Subcutaneous facial emphysema is a rare complication of tonsillectomy that can lead to infection, upper airway obstruction or invasion into the thorax. The latter can cause pneumomediastinum or pneumothorax, with possible subsequent cardiorespiratory function impairment. Although multiple causes are suggested in the literature, the main causative factor is still unclear. Moreover, the rationale for its management is inconsistent and the outcomes are unpredictable. We report a case of a 14-year-old pediatric male patient, known to have a hypersensitive gag reflex, who developed post-tonsillectomy cervicofacial subcutaneous emphysema; management has achieved complete clinical resolution after two weeks of complication onset. Additionally, we present a literature review that showcases the potential causes and management of subcutaneous emphysema.