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Severe subcutaneous and deep cervicofacial emphysema of unusual etiology

Published in European Archives of Oto-Rhino-Laryngology. 2012, vol. 269, no. 1, p. 303-8
Collection Open Access - Licence nationale Springer
Abstract Subcutaneous and deep cervical emphysema (SCE) in the head and neck are found in a wide spectrum of conditions. Most of them are seen in patients with midfacial trauma or oropharyngeal infections. Subcutaneous and deep cervical emphysema can also be a symptom of life-threatening mediastinitis and/or necrotizing fasciitis, both of which need immediate surgery. Rarely however does SCE occur in isolation as a consequence of elevated intraoral pressure in combination with or without visible lacerations of the oral mucosa. As a consequence, air penetrates the mucosal tears and results in subcutaneous emphysema even extending down to the mediastinum in severe cases. This article describes a series of five cases of isolated SCE. It discusses the diagnosis, the pathomechanism, the differential diagnosis and the treatment. It underlines the importance of anamnesis and careful physical and laboratory examinations in order to differentiate isolated SCE from more severe conditions such as necrotizing fasciitis or mediastinitis, which necessitate immediate surgery.
Keywords AdultChildFaceFemaleHumansMaleMiddle AgedNeckNeck Injuries/complicationsSubcutaneous Emphysema/diagnosis/etiology/therapyTooth Extraction/adverse effectsValsalva ManeuverWoundsPenetrating/complications
PMID: 21516502
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Article (Published version) (409 Kb) - public document Free access
Research groups Groupe Becker Minerva (imagerie ORL) (683)
Groupe Scolozzi Paolo (chirurgie maxillo-faciale et buccale) (896)
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TERZIC, Andréj et al. Severe subcutaneous and deep cervicofacial emphysema of unusual etiology. In: European Archives of Oto-Rhino-Laryngology, 2012, vol. 269, n° 1, p. 303-8. doi: 10.1007/s00405-011-1608-9 https://archive-ouverte.unige.ch/unige:26273

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Deposited on : 2013-02-07

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