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Extensive Subcutaneous Emphysema Post-Turbinate Surgery: Case Report on Mechanisms and Management
Ahmad Alkheder1,2, Nasser Alia2,3, Adel Azar1,2
1Department of Otorhinolaryngology, Al Mouwasat University Hospital, Damascus University, Syria.
Ear, Nose, & Throat Journal
|June 24, 2025
Summary
Subcutaneous emphysema is a rare complication after nasal surgery. This case report details extensive air infiltration following turbinate cauterization, emphasizing prompt imaging and multidisciplinary care for this potentially severe condition.
Area of Science:
- Otolaryngology
- Surgical Complications
- Medical Imaging
Background:
- Subcutaneous emphysema is a rare but serious complication following nasal surgery.
- It can rapidly spread to the face, neck, mediastinum, and thorax.
- This case highlights the potential for extensive air dissemination even after seemingly uneventful procedures.
Purpose of the Study:
- To report a case of extensive subcutaneous emphysema after nasal surgery.
- To discuss the potential mechanisms and management strategies.
- To emphasize key lessons for preventing and managing this complication.
Main Methods:
- A case report of a 40-year-old woman who developed extensive subcutaneous emphysema after turbinate cauterization and nostril reduction.
- Diagnostic workup included noncontrast computed tomography (CT), fiberoptic laryngoscopy, and bronchoscopy.
- Management involved multidisciplinary care, including mediastinal drainage.
Main Results:
- The patient developed widespread subcutaneous emphysema involving the face, neck, mediastinum, and thorax.
- CT confirmed extensive air infiltration; aerodigestive injuries were ruled out.
- Mediastinal drainage led to dramatic symptom resolution.
Conclusions:
- Inadvertent mucosal perforation during thermal ablation likely caused the emphysema.
- Early imaging and multidisciplinary management are crucial for atypical postoperative swelling.
- Judicious use of thermal energy and patient counseling are vital to prevent this complication.
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