Kemal Özgür, Demirel Emre, Çelebi Mehmet
Otolaryngology - Head and Neck Surgery, Ondokuz Mayıs University Faculty of Medicine, Samsun, TUR.
Cureus. 2024 Dec 14;16(12):e75709. doi: 10.7759/cureus.75709. eCollection 2024 Dec.
Cervical subcutaneous emphysema and pneumomediastinum without pneumothorax are exceedingly rare complications following rhinoplasty, with limited cases reported in the literature. This report presents a case of revision septorhinoplasty using autologous costal cartilage, where the patient complained of a sore throat 36 hours postoperatively. On physical examination, cervical subcutaneous emphysema was palpated, and radiologic evaluation confirmed both cervical subcutaneous emphysema and pneumomediastinum. An upper aerodigestive tract injury was ruled out as a potential cause. The probable mechanism involved damage to the inner perichondrium of the costal cartilage and endothoracic fascia with an intact pleura, explained in light of current literature, radiographic imaging, and anatomical illustration. This case report, combined with a literature review, provides insights into managing this unique complication and emphasizes the need for clinicians to recognize possible etiological factors related to surgical technique.
隆鼻术后出现无气胸的颈部皮下气肿和纵隔气肿是极其罕见的并发症，文献报道的病例有限。本报告介绍了一例使用自体肋软骨的鼻中隔鼻成形术翻修病例，患者术后36小时诉咽痛。体格检查时触诊发现颈部皮下气肿，影像学评估证实存在颈部皮下气肿和纵隔气肿。排除了上消化道气道损伤作为潜在病因。根据当前文献、影像学检查和解剖图示解释，可能的机制是肋软骨内层软骨膜和胸内筋膜受损而胸膜完整。本病例报告结合文献复习，为处理这一独特并发症提供了见解，并强调临床医生需要认识到与手术技术相关的可能病因。
