Cervicofacial emphysema: A systematic review

Cervicofacial Emphysema (CFE) is a self-limiting condition, defined by the presence of air in face and neck. The purpose of the manuscript is to systematically review the existing literature on CFE evaluation and management for updated clinical understanding of this condition. A literature search was conducted of publications about CFE on PubMed and Google Scholar by identifying all the articles with key search terms "Cervicofacial Emphysema" and "Sub Cutaneous Emphysema". Inclusion criteria were case series published in English between 1980 and 2024. In total, 241 case series were selected and reviewed to determine presenting symptoms, clinical signs and predisposing factors associated with CFE. Average age at diagnosis was 38.1 years, male and female are almost equally affected. The most common presenting symptoms were face and neck swelling. The most common finding was crepitus. The condition was most commonly reported in patients undergoing dental procedures, otorhinolaryngology procedures, or in patients who experienced transient change in intra nasal/thoracic pressure. The management includes clinical monitoring, reassurance of the patient, antibiotic prophylaxis and monitoring to rule out pneumomediastinum. The odds of concurrent pneumomediastinum is highest in patients with abdominal procedures as an etiology of CFE.