Cervical emphysema complicating excision of epiglottic cyst with carbon dioxide laser

Cervical emphysema is not uncommon in patients following head-and-neck related surgery. Free air may enter the neck by direct opening of the potential fascia spaces, dissection within the fascia spaces from the head or mediastinum and by injury to the upper respiratory of the alimentary tracts. The sources for free air in the neck are numerous and varied, ranging from the rectum to the sinuses. The otolaryngologist should have thorough knowledge of the differential diagnosis for air in the neck since the defi nitive therapy depends on the etiology. Here, a case of a 55-year-old female after undergoing excision of an epiglottic cyst with carbon dioxide laser is used to illustrate this clinical situation. Postoperative cervical emphysema developed and she was managed by supportive treatment with ideal recovery. Although cervical emphysema rarely occurs after microscopic suspension laryngoscopic laser surgery, it is still important to note this complication has the potential for grave outcomes if it is not immediately recognized and addressed.