Page 95 - Revista Portuguesa - SPORL - Vol 50 Nº1

Enfisema cervical postamigdalectomía

Cervical emphysema after tonsillectomy

Antonio Gómez-Torres Francisco Pérez Fernández Antonio Abrante Jiménez Antonio Medinilla Vallejo Francisco Esteban Ortega

RESUMEN ABSTRACT
La amigdalectomía, una de las cirugías más frecuentemente Tonsillectomy, one of the most frequently surgery performed
realizadas en otorrinolaringología, es un procedimiento in otolaryngology, is a relatively safe surgical procedure.
quirúrgico relativamente seguro. Sin embargo, numerosas However, several complications have been described. We
complicaciones han sido descritas. Presentamos el caso de report a case of an adult patient with cervical emphysema CASO CLÍNICO CASE REPORT
una paciente adulta con enfisema cervical tras ser sometida after undergoing tonsillectomy, a rare complication. A deeper
a amigdalectomía, una complicación poco frecuente.. Una dissection creates a discontinuity that dissects the cervical
disección más profunda crea una solución de continuidad que planes and allows the air to reach the mediastinum and
diseca los planos cervicales, pudiendo alcanzar el mediastino may cause a pneumothorax. Manoeuvres that increase the
y producir un neumotórax. Las maniobras que aumentan la air pressure on the upper airway favour and increase the
presión en la vía aérea superior favorecen el paso de aire y el emphysema.
aumento del enfisema. Keywords: cervical complications, emphysema, tonsillectomy.
Palabras clave: complicaciones cervicales, enfisema,
amigdalectomía.
INTRODUCTION
Several complications can be related to head and
neck surgery. Among these, there are subcutaneous
emphysema, pneumothorax and pneumomediastinum.
Subcutaneous emphysema has been described as a rare
complication following facial trauma, dental extraction,
1
tonsillectomy, adenoidectomy, and sinus surgery . A
deeper dissection than normal creates a discontinuity
that dissects the cervical planes. Manoeuvres that
increase the upper airway pressure (manual ventilation,
vomiting, coughing, etc.) increase the emphysema.
The purpose of this study is to analyse the mechanism,
morbidity, treatment and prevention of this condition.
Antonio Gómez-Torres
Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen del Rocío,
Sevilla, España CLINICAL CASE
Francisco Pérez Fernández A 20-year-old woman was admitted to the
Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen del Rocío,
Sevilla, España Otolaryngology Department to undergo tonsillectomy
for presenting recurrent tonsillitis. Preoperative tests
Antonio Abrante Jiménez
Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen del Rocío, and personal history showed no relevant medical history.
Sevilla, España
Tonsillectomy was performed with electrocautery under
Antonio Medinilla Vallejo
Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen del Rocío, general anaesthesia and tracheal intubation. Without
Sevilla, España
evidence of early postoperative complications, she was
Francisco Esteban Ortega discharged eight hours later.
Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen del Rocío,
Sevilla, España On the fourth postoperative day, she went to the
Emergency Service, presenting a three-day hemifacial
Correspondencia:
Dr. Antonio Gómez Torres. swelling, with laterocervical and inframandibular
Unidad de Gestión Clínica de Otorrinolaringología. Hospital Universitario Virgen Del Rocío.
Avda. Manuel Siurot, s/n 41013 – Sevilla crepitus. The skin showed no discoloration, there was
Teléfono: 680492165 no clinical or analytical data of respiratory failure, and
gotoa83@hotmail.com
vital sings were normal. Chest and neck radiographies
Los autores declaran no tener conflicto de intereses.

VOL 50 . Nº1 . MARÇO 2012 93