Uncommon but potential life-threatening complication after tonsillectomy: post-tonsillectomy cervicofacial surgical emphysema

[...]the patient was kept nothing by mouth and fed through a nasogastric tube. Patients with recurrent tonsillitis and previous peritonsillar abscess can develop fibrosis and adhesions of the tonsillar tissue to the fossa and underlying muscular layers as part of the healing process, which in turn can increase the risk of postoperative complications. 1 2 In our case, the most likely pathogenesis of this rare complication is the deep dissection into the tonsillar fossa and the superior pharyngeal constrictor muscle fibres because of pre-existing adhesions. If there is a clinically detectable defect with symptoms that are not responding to conservative measures, direct surgical repair of the tear might be another option. 1 3 Learning points Careful dissection is essential to prevent complications during tonsillectomy, especially in adults with history of peritonsillar abscess.