Subcutaneous and Mediastinal Emphysema after Microlaryngo Surgery

Abstract

  We report a case of a 51-year-old man who developed subcutaneous and mediastinal emphysema following microlaryngo surgery under mechanical controlled ventilation. While anesthesia was maintained, insertion of the direct laryngoscope caused hemodynamic instabilities including hypertension and tachycardia, which were refractory to intravenous beta blockade and Ca channel blockade. On day 2 he began to exhibit obvious symptoms of his emphysema and conservative therapy was continued. We suggest that the hemodynamic instabilities are related to the emphysema that was caused during direct laryngoscopy.