Subcutaneous emphysema as a complication of otorhinolaryngological surgical procedures.

Abstract

INTRODUCTION:

Subcutaneous emphysema (SE) represents, after bleeding and infections, a common complication in ENT surgery, given the intimate relationship between upper airways and anatomical area pertaining head and neck surgeon. Aim of this review is to analyze its characteristics, method of diagnosis and treatment to provide the specialist a useful tool for its early recognition.

EVIDENCE ACQUISITION:

A narrative review was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. A total of 164 articles were collected and most of them were case reports.

EVIDENCE SYNTHESIS:

Of 273 articles taken into consideration, only 164 met inclusion criteria. Review of all cases of SE in relation to surgical ENT procedures allow to classify each etiology on the surgical procedure that could be complicated with SE: laryngo-tracheal procedures, thyroid surgery, nasal and otological surgery, adenotonsillectomies. Moreover, traumatic orotracheal intubation, as well as alveolar rupture because of positive pressure ventilation or rupture of a preexisting abnormality, must be always taken into account.

CONCLUSIONS:

All ENT surgery can be complicated by SE. Diagnosis is simple and usually based only on physical examination, but correct and quick diagnosis is required. Treatment is in most of the time exclusively conservative, but SE could also represent a surgical emergency, given the possible evolution in pneumothorax/pneumomediastinum with serious consequences for patient's health.

• Authors: Luca Cerritelli, Alberto Caranti, Diana Ehsani, Claudio Moretti, Giuseppe Meccariello, Giovanni Cammaroto, Stefano Pelucchi
• Journal: Minerva surgery (Minerva Surg) Vol. 78 Issue 4 Pg. 401-412 (Aug 2023) ISSN: 2724-5438 [Electronic] Italy
• PMID: 36951677 (Publication Type: Review, Journal Article)

Topics

• Humans
• Subcutaneous Emphysema (diagnostic imaging, etiology)
• Otorhinolaryngologic Surgical Procedures (adverse effects)
• Mediastinal Emphysema (diagnostic imaging, etiology)
• Trachea
• Intubation, Intratracheal (adverse effects)