扁桃腺切除術併發皮下及縱膈氣腫

Subcutaneous Emphysema and Pneumomediastinum After Tonsillectomy

陳哲民(Che-Min Chen) ； 陳榮峰(Rong-Feng Chen) ； 謝坤衛(Kun-Wei Hsieh) ； 袁建漢(Chien-Han Yuan)

《台灣耳鼻喉頭頸外科雜誌》 47卷2期 (2012/04) Pp. 169-172

https://doi.org/10.6286/2012.47.2.169

摘要

扁桃腺切除是頭頸部常見的手術，其併發症包括出血、疼痛、感染及咽喉創傷等。相對於這些併發症，術後的皮下及縱膈腔氣腫則較為罕見。本科病例為一名32歲男性慢性扁桃腺炎併反覆急性發作的病人，在經氣管插管全身麻醉下接受兩側顎扁桃腺切除術，術後當日隨即發生頸部皮下氣腫及縱膈腔氣腫，經藥物保守治療後獲得改善。病人出院之後，持續門診追蹤半年復原情況良好。本文將討論其臨床症狀、診斷、治療及預後的相關情形，並探討如何避免及預防此併發症之發生，以供各位先進參考。

關鍵字

扁桃腺切除術 ； 皮下氣腫 ； 縱膈腔氣腫

並列摘要

Tonsillectomy is one of the most common surgical procedures of head and neck surgery. Comparing with the common complications of tonsillectomy include hemorrhage, pain, infection and laryngeal trauma. Subcutaneous emphysema and pneumomediastinum are relatively rare. We report the case of a 32-year-old man suffering from recurrent tonsillitis was admitted for tonsillectomy. Subcutaneous emphysema and pneumomediastinum developed after the date of tonsillectomy under general anaesthesia and with endotracheal intubation. His condition got improved gradually with conservative treatment. He has been regularly followed up for half of a year after discharge and showed good recovery. This article describes our experience with clinical symptoms, diagnosis, treatment and prognosis of this case, suggesting that it is very important to separate the tonsil from its fossa for avoiding complications.

並列關鍵字

tonsillectomy ； subcutaneous emphysema ； pneumomediastinum