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Cervicofacial emphysema following Harmonic scalpel tonsillectomy: case report and comprehensive review of the literature

Published online by Cambridge University Press:  19 December 2016

R A Crosbie  and
T Kunanandam
R A Crosbie*
Affiliation:
Department of Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK
T Kunanandam
Affiliation:
Department of Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK
*
Address for correspondence: Mr Robin A Crosbie, Department of Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK Fax: 0141 201 0000 E-mail: crosbie.robin@gmail.com
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Abstract

Background:

Tonsillectomy is one of the most common surgical procedures performed worldwide. There are a handful of common complications, with bleeding being the most feared; however, rarer complications can present to a wide range of medical professionals.

Methods:

A 12-year-old girl presented with cervicofacial emphysema following tonsillectomy. This paper discusses the case and the management adopted, and presents the findings of a comprehensive literature review.

Results:

The patient made a full recovery, and was discharged after 3 days following conservative management with intravenous broad-spectrum antibiotics and supplemental low-flow oxygen.

Conclusion:

This paper presents the first reported case of cervicofacial emphysema following Harmonic scalpel tonsillectomy. Although this is an exceptionally rare complication, it is potentially serious and warrants further description to improve awareness.

Keywords

TonsillectomyComplicationsEmphysema
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 2 , February 2017 , pp. 177 - 180
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 McNeill, RA. A history of tonsillectomy: two millennia of trauma, haemorrhage and controversy. Ulster Med J 1960;29:59–63 Google Scholar
2 Scottish Intercollegiate Guidelines Network. Management of sore throat and indications for tonsillectomy (2010). In: http://www.sign.ac.uk/guidelines/fulltext/117 [21 April 2016]Google Scholar
3 National Institute for Health and Care Excellence (NICE). Electrosurgery (diathermy and coblation) for tonsillectomy (2005). In: https://www.nice.org.uk/guidance/ipg150 [21 April 2016]Google Scholar
4 Cormack, RS, Lehane, J. Difficult tracheal intubation in obstetrics. Anaesthesia 1984;39:1105–11CrossRefGoogle ScholarPubMed
5 Prupas, HM, Fordham, SD. Emphysema secondary to tonsillectomy. Laryngoscope 1977;87:1134–6Google Scholar
6 Miman, MC, Ozturan, O, Durmus, M, Kalcioglu, MT, Gedik, E. Cervical subcutaneous emphysema: an unusual complication of adenotonsillectomy. Paediatr Anaesth 2001;11:491–3Google Scholar
7 Bizaki, A, Kääriäinen, J, Harju, T, Rautiainen, M. Facial subcutaneous emphysema after tonsillectomy. Head Face Med 2014;10:11 CrossRefGoogle ScholarPubMed
8 Parish, BD. A case of subcutaneous surgical emphysema: an unusual complication following the removal of faucial tonsils. Laryngoscope 1910;20:1046–8CrossRefGoogle Scholar
9 Richardson, CW. Tonsillectomy: consideration and its complications. Trans Am Laryngol Assoc 1912;34:170 Google Scholar
10 Rosenheim, S. Subcutaneous emphysema of the neck and chest following tonsillectomy in an epileptic. Trans Am Laryngol Rhinol Otol Soc 1922;337 Google Scholar
11 Richards, L. Subcutaneous emphysema complicating tonsillectomy. Boston Med Surg J 1923;189:203 Google Scholar
12 Stein, S. Surgical emphysema following tonsillectomy. Laryngoscope 1923;33:785 Google Scholar
13 von Hofe, FH. Emphysema of the head and neck complicating tonsillectomy. JAMA 1930;95:934 Google Scholar
14 Keen, JA. Medical and surgical complications of tonsillectomy in childhood. J Laryngol Otol 1932;47:1 Google Scholar
15 Stevenson, RS. Subcutaneous emphysema following tonsillectomy. J Laryngol Otol 1933;48:260 Google Scholar
16 MacCready, PB. Subcutaneous emphysema following tonsillectomy. Arch Otol 1935;42:331 Google Scholar
17 Baker, LJ. Subcutaneous emphysema complicating tonsillectomy. Can Med Assoc J 1936;34:670–1Google Scholar
18 Melgaard, KR. Subcutaneous emphysema after tonsillectomy. Acta Otolaryngol 1946;34:95–7Google Scholar
19 Ferguson, CC, McGarry, PM, Beckman, IH, Broder, M. Surgical emphysema complicating tonsillectomy and dental extraction. Can Med Assoc J 1955;72:847–8Google ScholarPubMed
20 Anderson, BR. Subcutaneous emphysema: a complication of tonsillectomy. AMA Arch Otolaryngol 1958;68:697–9Google Scholar
21 Podoshin, L, Persico, M, Fradis, M. Posttonsillectomy emphysema. Ear Nose Throat J 1979;58:73–6Google Scholar
22 Hampton, SM, Cinnamond, MJ. Subcutaneous emphysema as a complication of tonsillectomy. J Laryngol Otol 1997;111:1077–8Google Scholar
23 Marioni, G, De Filippis, C, Tregnaghi, A, Gaio, E, Staffieri, A. Cervical emphysema and pneumomediastinum after tonsillectomy: it can happen. Otolaryngol Head Neck Surg 2003;128:298–300 CrossRefGoogle ScholarPubMed
24 Nishino, H, Kenmochi, M, Kasugai, S, Okada, T, Ohashi, T. Subcutaneous emphysema secondary to tonsillectomy: a case report. Auris Nasus Larynx 2003;30:S135–6 Google Scholar
25 Fechner, FP, Kieff, D. Cervical emphysema complicating tonsillectomy with argon beam coagulation. Laryngoscope 2003;113:920–1Google Scholar
26 Yammine, NV, Alherabi, A, Gerin-Lajoie, J. Post-tonsillectomy subcutaneous emphysema and pneumomediastinum. J Otolaryngol 2004;33:403–4Google Scholar
27 Watanabe, K, Kunitomo, M, Yamauchi, Y, Kimura, M, Masuno, S, Aoki, H et al. Subcutaneous emphysema after tonsillectomy: a case report. J Nippon Med Sch 2004;71:111–13Google Scholar
28 Stewart, AE, Brewster, DF, Bernstein, PE. Subcutaneous emphysema and pneumomediastinum complicating tonsillectomy. Arch Otolaryngol Head Neck Surg 2004;130:1324–7Google Scholar
29 Panerari, AC, Soter, AC, Silva, FL, Oliveira, LF, Neves, MD, Cedin, AC. Onset of subcutaneous emphysema and pneumomediastinum after tonsillectomy: a case report. Braz J Otorhinolaryngol 2005;71:94–6Google Scholar
30 Gillot, C, Tombu, S, Crestani, V, Huvelle, P, Moreau, P. Subcutaneous emphysema and mediastinitis: unusual complications of tonsillectomy. B-ENT 2005;1:197–200 Google Scholar
31 Lima, WL, Correa, NS, de Campos, JL, Navarro, PM, Correia Lde, O. Subcutaneous emphysema after tonsillectomy: case report. Rev Bras Anestesiol 2005;55:441–4Google ScholarPubMed
32 Shine, NP, Sader, C, Coates, H. Cervicofacial emphysema and pneumomediastinum following pediatric adenotonsillectomy: a rare complication. Int J Pediatr Otorhinolaryngol 2005;69:1579–82Google Scholar
33 Patel, N, Brookes, G. Surgical emphysema following tonsillectomy. Ear Nose Throat J 2005;84:660–1Google Scholar
34 Villagra Siles, EJ, Rodríguez Perales, MA, García Mendoza, A, Zaiden Torrez, A. Cervical emphysema after tonsillectomy: a case report [in Spanish]. Acta Otorrinolaringol Esp 2006;57:251–2Google Scholar
35 Anwar, MM, Bhattacharjee, N. Surgical emphysema after tonsillectomy. JCMCTA 2007;18:32–4Google Scholar
36 Hung, MH, Shih, PY, Yang, YM, Lan, JY, Fan, SZ, Jeng, CS. Cervicofacial subcutaneous emphysema following tonsillectomy: implications for anesthesiologists. Acta Anaesthesiol Taiwan 2009;47:134–7Google Scholar
37 Kim, JP, Park, JJ, Kang, HS, Song, MS. Subcutaneous emphysema and pneumomediastinum after tonsillectomy. Am J Otolaryngol 2010;31:212–15CrossRefGoogle ScholarPubMed
38 Al Omari, B, Sadacharam, M, Sheahan, P. Cervical surgical emphysema following routine tonsillectomy. Rev Laryngol Otol Rhinol (Bord) 2011;132:241–3Google Scholar
39 Koukoutsis, G, Balatsouras, DG, Ganelis, P, Fassolis, A, Moukos, A, Katotomichelakis, M et al. Subcutaneous emphysema and pneumomediastinum after tonsillectomy. Case Rep Otolaryngol 2013;2013:154857 Google Scholar
40 Yelnoorkar, S, Issing, W. Cervicofacial surgical emphysema following tonsillectomy. Case Rep Otolaryngol 2014;2014:746152 Google Scholar
41 Al Jabr, I, Al Harethy, S. Cervicofacial subcutaneous emphysema: a rare complication of tonsillectomy. EJENTAS 2014;15:49–51 Google Scholar
42 Tran, DD, Littlefield, PD. Late presentation of subcutaneous emphysema and pneumomediastinum following elective tonsillectomy. Am J Otolaryngol 2015;36:299–302 CrossRefGoogle ScholarPubMed
43 Dutta, NN, Bordoloi, BM. Tonsillectomy using harmonic scalpel. Indian J Otolaryngol Head Neck Surg 2002;54:74–6CrossRefGoogle ScholarPubMed