Subcutaneous Emphysema Following Tonsillectomy: A Rare Complication of a Common Surgery

Abstract

Post-tonsillectomy emphysema is an infrequent yet critical complication that follows tonsillectomy - a prevalent surgical procedure for treating conditions like recurrent tonsillitis and obstructive sleep apnea. While tonsillectomy is generally safe, it is not without risks, including the rare occurrence of postoperative emphysema, where air accumulates abnormally in the neck and head's soft tissues, potentially leading to severe respiratory distress. We present a case of a middle-aged female who underwent tonsillectomy and subsequently developed symptoms indicative of post-tonsillectomy emphysema. Diagnosed through a combination of physical examination and imaging, her treatment involved conservative management and careful monitoring, ultimately resulting in full recovery without the need for surgical intervention.

Keywords: emphysema post tonsillectomy; iatrogenic subcutaneous emphysema; post-tonsillectomy complication; subcutaneous emphysema; surgical emphysema.

Figure 1. The plain anterior-posterior (AP) X-ray

The arrow pointing to soft tissue lucency on the left side of the neck.

Figure 2. Computed tomography (CT) with contrast, axial view

The arrow pointing to the area of extension of air to the left parapharyngeal space.

Figure 3. CT with contrast, coronal view

The arrow pointing to air extending to parapharyngeal space into the rest of the neck spaces on the left side.