[Emphysema as a leading symptom].

Air may enter the tissue via injuries of the respiratory and alimentary tracts. The mechanisms governing the entrance of air are traumas, and surgical or anaesthesiological measures; spontaneous entry is also possible. Infections with aerogenic bacteria are very rare. Numerous possible aetiologies for the accumulation of air in the head and neck have been reported. Case reports are given to discuss the pathomechanism and therapy of emphysema as a result of injuries of cranium and larynx, dental treatment, whiplash injury, adenotonsillectomy and spontaneously in asthma. The otolaryngologist should have thorough knowledge of differential diagnosis and prophylactic measures, since therapy depends upon the aetiology.