Cervical Aerocele: A Rare Delayed Complication of Tracheostomy

When Air is the Complication: Emphysema Following Tracheostomy

“…I read with great interest a case report entitled: ‘Cervical aerocele: a rare delayed complication of tracheostomy’ published in the November 2018 issue of the Oman Medical Journal . 1 It is such a rare complication to occur following a common symptom, which was prolonged cough.…”

“…In the reported case, chronic cough occurred eight years after the procedure had led to the collection of air under the skin. 1 This was possible as the slowly fibrosed tracheocutaneous tract will be prevented from complete closure following chronic cough that weakened the anterior tracheal wall. Eventually, the chronicity of the symptom tends to make the air-containing space developed, persistent, and enlarged with time.…”

Letter in Reply: When the Air is the Complication

“…We thank the authors for their letter, 1 regarding our case of cervical aerocele: a rare delayed complication of tracheostomy. 2 …”

Tracheocele Showing a Distinctive Bullfrog-breathing Pattern

“…Although it may be congenital, it most commonly results from surgeries involving the trachea such as tracheostomy, tracheal resection, and tracheocutaneous fistula repair. 1 Anatomically, this unusual breathing pattern occurs because rigid tracheal rings hold patent a tracheal defect throughout the respiratory cycle that allows both the exit and the re-entry of expired air to the trachea. Physiologically, the subcutaneous reservoir increases work of breathing by adding significant dead space, eventually leading to hypercapnia, hypoxemia, and respiratory failure.…”

“…Although it may be congenital, it most commonly results from surgeries involving the trachea such as tracheostomy, tracheal resection, and tracheocutaneous fistula repair. 1…”