A case report of unusual pneumomediastinum after endoscopic sinus surgery

Alomari, Ahmad I.; Alzoubi, Firas; Khatatbeh, Abdullah

doi:10.1016/j.ijscr.2016.11.028

Cited by 2 publications

(4 citation statements)

References 9 publications

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“…The etiology is most often found to be trauma secondary to intubation and anesthesia, or trauma to the lamina papyracea. [5][6][7] In the case presented in this report, the negative post-operative CT scans make tracheal or esophageal trauma during intubation unlikely, although a micro laceration of the trachea cannot be definitively excluded. There may have also been a microfracture of the lamina that was not appreciated on postoperative imaging.…”

Section: Discussionmentioning

confidence: 99%

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A Case of Mediastinal Emphysema Following Functional Endoscopic Sinus Surgery

et al. 2022

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Mediastinal emphysema is an extremely rare and potentially fatal complication of endoscopic sinus surgery. The case presented involves a 73-year-old man who developed mediastinal emphysema following endoscopic sinus surgery for severe sinonasal polyposis. We describe the multiple etiologies that may have contributed to his condition including possible microtrauma at the time of intubation or during intubation, microfracture of the orbital wall/lamina papyracea, and severe hiccups.

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Section: Discussionmentioning

confidence: 99%

“…4 Mediastinal emphysema, specifically, may lead to a dangerous sequalae that may result in mediastinitis, septicemia, and even death. 5 Because of this, its prompt recognition and treatment is necessary to reduce patient morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

A Case of Mediastinal Emphysema Following Functional Endoscopic Sinus Surgery

et al. 2022

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“…Причиной данного осложнения, по мнению авторов, выступило повреждение бумажной пластинки. Объяснением этому служит ретроградное распространение воздуха через подвисочную ямку, ретро-и парафарингеальные пространства в мышечно-апоневротические слои лица и шеи, а далее -в средостение (из-за тесной связи с ним) [17].…”

Section: Fig 4 Ct-signs Of Subcutaneous Emphysema Of the Soft Tissues Of The Neck (Indicated By The Blue Arrow) Pneunomediastinum (Indicaunclassified

“…Попадание воздуха в подкожно-жировую клетчатку и средостение при эндоскопических операциях на околоносовых пазухах встречается редко. Причинами этого могут быть как непосредственно хирургическое вмешательство [17], так и его анестезиологическое сопровождение [18].…”

Section: Introductionunclassified

Subcutaneous emphysema and pneumomediastinum after endoscopic transnasal removal of nasopharyngeal angiofibroma

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Voronov

Dvorianchikov

et al. 2021

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Introduction. Juvenile nasopharyngeal angiofibroma is a rare, benign, well-vascularized tumor of the skull base characterized by destructive growth. The development of endoscopic techniques and experience of surgeons have enabled the removal of this tumor both at early stages and late stages (advanced disease). Patients may develop various complications in the intraoperative and postoperative periods, including massive bleeding, nasal liquorrhea, facial paresthesia, lacrimal hyposecretion, etc. Air penetration into the subcutaneous fat and mediastinum during endoscopic surgery on the paranasal sinuses is rare. Such complication as subcutaneous emphysema and pneumomediastinum after endoscopic endonasal removal of juvenile nasopharyngeal angiofibroma has not been reported in the literature.Case report. A 19-year-old male patient has undergone endoscopic endonasal removal of juvenile nasopharyngeal angiofibroma. The tamponade was removed within the first 24 h postoperatively. Ten hours after it, the patient developed subcutaneous emphysema and pneumomediastinum triggered by sneezing. The diagnosis was confirmed by computed tomography of the neck and chest. The patient was transferred to the intensive care unit and received conservative treatment (including infusion, antibacterial, and antiinflammatory therapy). The symptoms of subcutaneous emphysema and pneumomediastinum subsided in response to treatment. Follow-up examinations (computed tomography and magnetic resonance imaging) confirmed that the tumor had been completely removed. The patient was discharged in a satisfactory condition.Conclusion. Subcutaneous emphysema and pneumomediastinum are exceedingly rare complications of endoscopic endonasal removal of juvenile nasopharyngeal angiofibroma and are caused by anatomical connection between the parapharyngeal / retropharyngeal spaces and mediastinum. To prevent such complications, it is necessary to keep tampons in the nasal cavity for at least 2 days, as well as to instruct patients after surgery (avoid sneezing with their mouth closed, lifting weights, coughing, and vomiting). The nasoseptal flap used to repair the nasopharyngeal defect after tumor removal also ensures its sealing. Patients with complications should undergo computed tomography of the neck and chest (in case of emergency) and should be transferred to an intensive care unit. Conservative treatment (antibacterial and antiinflammatory therapy) will ensure good results in most patients.

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A case report of unusual pneumomediastinum after endoscopic sinus surgery

Cited by 2 publications

References 9 publications

A Case of Mediastinal Emphysema Following Functional Endoscopic Sinus Surgery

A Case of Mediastinal Emphysema Following Functional Endoscopic Sinus Surgery

Subcutaneous emphysema and pneumomediastinum after endoscopic transnasal removal of nasopharyngeal angiofibroma

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