Subcutaneous Emphysema after Tonsillectomy: A Case Report

We experienced a case of a subcutaneous emphysema after tonsillectomy. The patient, a 24-year-old man, complained of a recurrent sore throat and was diagnosed as having chronic tonsillitis. Pre-operative general examinations revealed no abnormalities. The operation was carried out under general anesthesia. The adhesions between the tonsils and the surrounding tissues were moderate. The bi-lateral tonsils were easily removed. The recovery period was uneventful. On the next morning, marked swelling of the left cheek and submandibular area was noted. On palpation, there was a characteristic crepitation and softness in these areas. The X-ray examination revealed subcutaneous emphysema. There was no finding of airway obstruction. We diagnosed him as having a subcutaneous emphysema and administered antibiotics for 5 days. From clinical findings, the subcutaneous emphysema was thought to be caused by surgical rather than anesthetic factors. The subcutaneous emphysema gradually disappeared. One year after the tonsillectomy, the patient is under observation as an outpatient and is free from any abnormal symptoms. To avoid this kind of complication, we should pay attention to carefully separate the tonsil from its fossa and to make appropriate selection of surgical equipments.