Subcutaneous Emphysema following Emergent Surgical Conventional Tracheostomy

Abstract

In maxillofacial surgery, tracheostomy is indicated in congenital, inflammatory, oncologic, or traumatic respiratory obstruction. In traumatic cases, however, it is sometimes hard to implement. We describe subcutaneous emphysema following emergent surgical conventional tracheostomy performed after stab injury to the floor of the mouth. We analyze the course that led to this complication and discuss suggestions on how to avoid it. In addition, we review the literature to improve our knowledge and practice regarding this entity. Massive subcutaneous neck emphysema occurred because ventilation started at the time when the hemorrhage was not completely managed and the tracheal tube was not fully secured. In traumatic cases with profound bleeding, hemorrhage management must be performed carefully. The recommendation not to ventilate until the hemorrhage is completely managed should be observed.

Conservative Management of Subcutaneous Emphysema: A Case Series

“…By consider ing the specific etiologies and employing appropria te interventions, healthcare professionals can effe ctively manage subcutaneous emphysema in pediatric p atients, ensuring optimal outcomes and minimizing t he impact on their overall well-being. Continued re search and understanding of subcutaneous emphysema a re crucial to further enhance diagnostic techniques and management strategies for this condition 11 Harrison et al documented two intriguing cases of s urgical emphysema in pediatric patients, shedding l ight on the potential complications that can arise f rom seemingly minor injuries. The first case involv ed a significant tear in the trachea, leading to ex tensive surgical emphysema.…”

“…Additional ly, alternative antibiotics such as clindamycin, ce ftriaxone, ampicillin, ciprofloxacin, and cefuroxim e can also be considered. Empirical antibiotic cove rage is recommended to reduce the risk of secondary infections, especially when air enters the body thr ough a contaminated route, as the introduction of a ir often carries microorganisms from the surroundin g flora 11,13 Subcutaneous emphysema can manifest as either a sel f-limited condition or a medical/surgical emergency that requires prompt intervention. In extensive cas es of subcutaneous emphysema, needle decompression h as proven to be effective in relieving pressure, wh ile the use of antibiotics helps reduce mortality r ates.…”

A Case of Massive Subcutaneous Emphysema and Pneumomediastinum Due to Dehiscence of Stoma After Emergent Tracheostomy

“…2,3 Subcutaneous emphysema chiefly results from the misposition of the cannula and is extremely rare for other reasons. 5…”

“…2,3 Subcutaneous emphysema chiefly results from the misposition of the cannula and is extremely rare for other reasons. 5 Symptoms of emphysema in the head and neck area and mediastinum include swelling of the neck, neck and chest pain, dysphonia, sore throat and dysphagia, and crepitus can be felt within the range of emphysema. 6 A diagnosis can be easily rendered by simple chest and neck radiographs, and the CT scan can be considered for more accurate evaluation.…”