[Subcutaneous emphysema of the neck following tonsillectomy].
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We report a case of early pace-maker malfunction associated with a collection of air which separates the anodal contact plate of a unipolar permanent generator from the underlying tissues. The air pocket resulted from a complication of the percutaneous technique used to introduce the electrocatheter through the subclavian vein. Loss of capture was attributed to a critical increase in impedance to current flow in the pacing system. The malfunction was corrected by simple non-invasive procedures at the patient's bedside. Air pocket can cause the loss of stimulation of the pace-maker.
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Removal of the tonsils and adenoid tissue because of recurrent infection and/or respiratory obstruction is one of the most commonly performed operations. A rare complication during this intervention is subcutaneous surgical emphysema. The awareness of anaesthesiologists and otolaryngological surgeons will protect the patient from serious consequences. We report our experience with this complication and provide a review of the literature.
The presence of air in the retropharyngeal and cervical subcutaneous spaces of the neck in association with the acute onset of severe odynophagia and dysphagia is an uncommonly recognized initial feature of pneumomediastinum. Free air in the mediastinum extends into the neck via fascial planes. Spontaneous pneumomediastinum is a self-limited disorder that can be confused with Boerhaave's syndrome (spontaneous esophageal perforation), which is potentially fatal. The diagnosis is established radiologically.
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