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鼻中隔成形术后的颈部皮下气肿和纵隔气肿

Cervical subcutaneous emphysema and pneumomediastinum after septorhinoplasty.

作者信息

Kim Eun Sung, Kang Ju Wan, Kim Chang-Hoon, Hong Jae Min

机构信息

From the Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

J Craniofac Surg. 2014 Mar;25(2):533-4. doi: 10.1097/SCS.0000000000000693.

Abstract

Cervical and facial subcutaneous emphysema is mainly caused by maxillofacial trauma or head and neck surgery. There are only 2 cases of subcutaneous emphysema after septorhinoplasty in the English literature. We report a case of subcutaneous emphysema and pneumomediastinum after a septorhinoplasty.A healthy 35-year-old man with nasal obstruction and dissatisfaction with the shape of his nose was referred to our outpatient clinic. The patient had a septorhinoplasty including bilateral medial and lateral osteotomy under general anesthesia. On the fifth day after the surgery, the patient visited the emergency department with swelling and pain in the right submandibular area and cheek. On computed tomographic (CT) scans, air was observed in the right temporal space, masticator space, submandibular space, and superior mediastinal space. He was immediately hospitalized for administration of intravenous antibiotics and bed rest.On the fifth day after the hospitalization, follow-up CT scans were performed. Subcutaneous emphysema and pneumomediastinum were markedly decreased. The patient was discharged on the fifth day.

摘要

颈部和面部皮下气肿主要由颌面创伤或头颈外科手术引起。英文文献中鼻中隔成形术后仅出现2例皮下气肿病例。我们报告1例鼻中隔成形术后出现皮下气肿和纵隔气肿的病例。一名35岁健康男性,因鼻塞和对鼻外形不满意前来我院门诊就诊。该患者在全身麻醉下接受了包括双侧内外侧截骨术的鼻中隔成形术。术后第5天,患者因右下颌下区和面颊肿胀疼痛前往急诊科就诊。在计算机断层扫描(CT)中,右侧颞间隙、咀嚼肌间隙、下颌下间隙和上纵隔间隙均观察到气体。他立即住院接受静脉抗生素治疗并卧床休息。住院第5天进行了CT复查。皮下气肿和纵隔气肿明显减轻。患者于第5天出院。

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