Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-26T13:55:20.850Z Has data issue: false hasContentIssue false
  • English
  • Français

Cervical emphysema: an unusual presentation of laryngeal cancer

Published online by Cambridge University Press:  13 March 2014

T Pézier ,
B Schuknecht ,
S Schmid  and
G Huber
T Pézier*
Affiliation:
ENT and Head and Neck Clinic, University Hospital Zurich, Switzerland
B Schuknecht
Affiliation:
Radiology Department, MRI Bethanien, Zurich, Switzerland
S Schmid
Affiliation:
ENT and Head and Neck Clinic, University Hospital Zurich, Switzerland
G Huber
Affiliation:
ENT and Head and Neck Clinic, University Hospital Zurich, Switzerland
*
Address for correspondence: Dr T Pezier, ENT and Head and Neck Clinic, University Hospital Zurich, Frauenklinikstrasse 24, 8008 Zurich, Switzerland E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Acute respiratory decompensation can occur on a background of slowly progressive airway compromise, for example in laryngeal squamous cell cancer. Surgeons in ENT, together with anaesthetists, are often asked to evaluate airway risk and as yet there is no widely adopted standardised approach.

Case report:

This paper reports the case of an 82-year-old male, who presented with acute airway compromise due to both endolaryngeal obstruction from a squamous cell cancer and extralaryngeal compression from massive subcutaneous emphysema.

Results:

Primary total laryngectomy was performed, but the patient declined adjuvant radiotherapy. He died a year later from a heart attack without evidence of recurrence.

Conclusion:

To the best of our knowledge, this is the first case report of acute airway compromise from extralaryngeal subcutaneous emphysema secondary to laryngeal cancer. Options for acute airway management are discussed.

Keywords

Laryngeal CancerEmphysemaAirway ManagementAirway Obstruction
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 3 , March 2014 , pp. 299 - 301
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Dissanaike, S, Shalhub, S, Jurkovich, GJ. The evaluation of pneumomediastinum in blunt trauma patients. J Trauma 2008;65:1340–5Google ScholarPubMed
2Baumgartner, F, Sheppard, B, de Virgilio, C, Esrig, B, Harrier, D, Nelson, RJ et al. Tracheal and main bronchial disruptions after blunt chest trauma: presentation and management. Ann Thorac Surg 1990;50:569–74CrossRefGoogle ScholarPubMed
3Kolber, MR, Aspler, A, Sequeira, R. Conservative management of laryngeal perforation in a rural setting: case report and review of the literature on penetrating neck injuries. CJEM 2011;13:127–32Google Scholar
4Luers, JC, Bovenschulte, H, Beutner, D. Perforation of the hypopharynx after esophagogastroduodenoscopy [in German]. Dtsch Med Wochenschr 2012;137:1045–8Google ScholarPubMed
5Wei, JL, Bond, J. Management and prevention of endotracheal intubation injury in neonates. Curr Opin Otolaryngol Head Neck Surg 2011;19:474–7CrossRefGoogle ScholarPubMed
6Steinbacher, R, von Ritgen, S, Moens, YP. Laryngeal perforation during a standard intubation procedure in a pig. Lab Anim 2012;46:261–3CrossRefGoogle ScholarPubMed
7Dursun, G, Ozgursoy, OB, Beton, S, Batikhan, H. Current diagnosis and treatment of laryngocele in adults. Otolaryngol Head Neck Surg 2007;136:211–15Google Scholar
8American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2003;98:1269–77CrossRefGoogle Scholar
9Moorthy, SS, Gupta, S, Laurent, B, Weisberger, EC. Management of airway in patients with laryngeal tumors. J Clin Anesth 2005;17:604–9Google Scholar
10Hassani, DA, Bhananker, SM. Postoperative airway obstruction after airway tumor debulking. J Anesth 2006;20:237–9CrossRefGoogle ScholarPubMed
11Laccourreye, O, Lawson, G, Muscatello, L, Biacabe, B, Laccourreye, L, Brasnu, D. Carbon dioxide laser debulking for obstructing endolaryngeal carcinoma: a 10-year experience. Ann Otol Rhinol Laryngol 1999;108:490–4Google Scholar
12Pezier, TF, Nixon, IJ, Joshi, A, Pang, L, Guerrero-Urbano, T, Oakley, R et al. Pre-operative tracheostomy does not impact on stomal recurrence and overall survival in patients undergoing primary laryngectomy. Eur Arch Otorhinolaryngol 2013;270:1729–35Google Scholar
13Narula, AA, Sheppard, IJ, West, K, Bradley, PJ. Is emergency laryngectomy a waste of time? Am J Otolaryngol 1993;14:21–3Google Scholar