Bodenez C, Houliat Th, Lacher Fougère S, Traissac L
CHU Pellegrin, Tripode, Clinique ORL, Place A. Raba Léon, F-33076 Bordeaux, France.
Rev Laryngol Otol Rhinol (Bord). 2003;124(3):195-8.
Spontaneous cervical subcutaneous emphysema, without any aetiology found in the clinical history, is far less common than subcutaneous cervical emphysema following trauma, surgery, or infectious cervical processes. In this recent case report, the authors describe a young woman who developed a cervical subcutaneous emphysema. No responsible factor had been found. Radiological investigations revealed a pneumomediastinum, which is an uncommon but a serious complication of cervical emphysema. The CT-scan highlighted a rupture of the crico-thyroid membrane, from which the air had followed the fascial planes up to the neck and the mediastinum. The authors describe the treatment and clinical course. They put forward an embryological hypothesis regarding the spontaneous crico-thyroid membrane rupture. A congenital fragility of this area could exist which could explain its breach. The pathogenesis and management of spontaneous cervical emphysema are discussed in the light of diverses articles about this subject. The radiological or surgical explorations which may be used in this aetiological diagnosis and treatment are given.
自发性颈部皮下气肿在临床病史中未发现任何病因,远比创伤、手术或感染性颈部病变后发生的颈部皮下气肿少见。在这份最新的病例报告中,作者描述了一名出现颈部皮下气肿的年轻女性。未发现相关责任因素。影像学检查显示存在纵隔气肿,这是颈部气肿一种虽不常见但严重的并发症。CT扫描突出显示了环甲膜破裂,空气由此沿着筋膜平面上行至颈部和纵隔。作者描述了治疗方法和临床过程。他们提出了一个关于自发性环甲膜破裂的胚胎学假说。该区域可能存在先天性脆弱性,这可以解释其破裂原因。根据关于该主题的各种文章,讨论了自发性颈部气肿的发病机制和处理方法。给出了可用于该病因诊断和治疗的影像学或手术探查方法。