• Journal of Chest Surgery
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• v.29 no.2
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• pp.208-212
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• 1996

From 1990 to 1994, 10 patients were treated for tracheobronchial injury due to blunt trauma. 7 injuries resulted from motor vehicle accident. Common presenting signs included subcutaneous emphysema, dyspnea and hemoptysis. The most common radiologic findings were pneumothorax, pneumomediastinum and hemothorax. The fiberoptic bronchoscopy was highly accurate method for the diagnosis. The operation method is simple closure except one patien underwent right pneumonectomy. One patient died because of respiratory distress and 9 patients recovered uneventfully and returned to normal activity. Early recognition and proper treatment of tracheobronchial injury is important.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.785-788
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• 2007

Epidural emphysema and pneumoscrotum with subcutaneous emphysema are rare in a child past the neonatal period. Their most common causes are bronchial asthma and respiratory infection. Here, we report an 18-month-old boy who was presented with severe air leak, consisting of epidural emphysema, pneumoscrotum, subcutaneous emphysema, and pneumomediastinum, complicated by a bronchial foreign body. The air leak was resolved dramatically after removing the foreign body.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.12.1-12.5
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• 2018

Background: Subcutaneous emphysema refers to swelling caused by the presence of air or gas in the interstices of loose connective tissue. In the head and neck area, it may follow the fascial planes and is characterized by sudden swelling, crepitus on palpation, infrequent pain, and air emboli on radiography. It usually occurs as a complication in dental treatment. Some reports have described subcutaneous emphysema caused by dental procedures; however, severe emphysema related to peri-implantitis after treatment has not been documented. Accordingly, the current report describes a rare case of subcutaneous cervical emphysema resulting from the use of an air-powder abrasive device to treat peri-implantitis. Case presentation: Based on a review of the existing literature and the present case, nine cases of subcutaneous emphysema due to air-powder abrasive device have been reported. In most cases, the emphysema resolved over time after treatment with prophylactic antibiotics; among these, two were related to peri-implantitis management. Conclusion: Considering the frequent use of air-powder abrasive devices to treat peri-implantitis, the potential risk of iatrogenic emphysema related to this procedure needs to be addressed more extensively.

• Korean Journal of Bronchoesophagology
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• v.14 no.2
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• pp.10-16
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• 2008

Surgical resection and reanastomosis has been the treatment of choice in patients with tracheobronchial stenosis. Recent development of bronchoscopic intervention has been replacing the role of surgery in these patients. After summarizing the upto date data of bronchoscopic intervention, the proper management of tracheobronchial stenosis will be presented. Bronchoscopic intervention would be much effective when performed under rigid bron- choscopy, due to the stable patients' condition and endoscopic view. The usual method of intervention includes ballooning, Nd-YAG laser resection, bougienation, mechanical airway dilatation, stenting and photodynamic therapy. Silicone stents are very effective in patients with tracheobronchial stenosis to maintain airway patency. Bronchoscopic intervention provided immediate symptomatic relief and improved lung function in most of patients. After airway stabilization, stents were removed successfully in 2/3 of the patients at a 12-18 months post-insertion. Less than 5% of patients eventually needs surgical management. Acute complications, including excessive bleeding, pneumothorax, and pneumomediastinum develops in less than 5% of patients but managed without mortality. Stent-related late complications, such as, migration, granuloma formation, mucostasis, and restenosis are relatively high but usually controlled by follow-up bronchoscopy. In conclusion, bronchoscopic intervention, including silicone stenting could be a useful and safe method for treating tracheobronchial stenosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.6
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• pp.538-542
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• 2010

Acute mediastinitis is a fatal infection which occurs related to connective tissue of mediastium, in the thoratic organs. Occurrence of mediastinitis due to craniocervical infection is very rare, and is defined as descending necrotizing mediastinitis. November 8th, 2008, man in his early fifties visited ER due to severe swelling on left neck area and dyspnea. Antibiotic were administered immediately, and vast amount of abscess formation on pneumomediastinum and adjacent tissues were observed via chest computed tomography. With cooperation of thoracic and cardiovascular surgery department, emergency incision and drainage with drain insertion was done to remove abscess, and control the infection. After surgery, everyday saline irrigation through drain was done during hospitalization, with continues antibiotic therapy. Descending necrotising mediastinitis is a most rare and dangerous infection which occurs on oropharyngeal area. In case of descending necrotising mediastinitis, accurate diagnosis, airway maintenance, remove of abscess by incision and drainage, aggressive antibiotic therapy and continuous saline irrigation is necessary to increase patient survivability. Also, computed tomography with contrast media is essential to figure out the size and location of the infection and abscess formation.

• Pediatric Infection and Vaccine
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• v.19 no.3
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• pp.162-167
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• 2012

Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract infection in infants. Life-threatening RSV infection is often reported in young children and immunocompromised hosts. Since there is no report on ribavirin therapy for RSV pneumonia in pediatric cancer patients in Korea, we report one case of RSV pneumonia that developed in an infant with acute lymphoblastic leukemia (ALL). Despite administration of oral ribavirin and intravenous immunoglobulin, the patient's respiratory distress worsened and admission to an intensive care unit was necessary. Chest x-ray showed multifocal consolidation, pneumothorax, and pneumomediastinum. Treatment with aerosolized ribavirin led to significant clinical improvement. The role of aerosolized ribavirin is still controversial, but it might have a therapeutic potential for severe RSV pneumonia in children with leukemia.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.244-247
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• 1996

Multiple symmetric lipomatosis is a rare disease characterized by progressive growth of subcutaneous fat masses which are located symmetrically at neck, shoulders, chest, abdomen and groin. Recent surveys revealed a high incidence of combined somatic and autonomic neuropathy. The exact cause of the disease is not known. We have experienced one case of multiple symmetric lipomatosis with mediastinal involvement with symptomatic compression of trachea. The patient was a 55-year-male, complaining of dyspnea and slowly enlarging multiple symmetric masses at the neck, shoulders, chest, abdomen, flank and groin over a period of 10 years. He had a habit of excessive alcohol intake for many years. The fatty masses in the neck and the upper mediastinum including peritracheal region were excised through transverse cervical incision. But, because of the incomplete excision of peritracheal fatty tissue, we performed reoperation for the relief of residual tracheal compression at the 15th postoperative day. Two days later emergent tracheostomy was performed due to postoperative pneumomediastinum and subcutaneous emphysema. He could discharge with permanant tracheostomy.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.235-238
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• 1996

Acquired tracheoesophageal fistula, a life threatening lesion, is rare but occurs most frequently alter prolonged mechanical ven ilation using a cuffed endotracheal tube. The mechanism of injury seems to be ischemia and inflammation of compressed trachea and esophagus by cuffed endotracheal tube. The patient was a 25 years old pregnant woman who was on prolonged mechanical ventilation for bacterial meningitis secondary to untreated otitis media. 40 days after mechanical ventilation, sudden subcutaneous empysema and pneumomediastinum ocurred and these were due to tracheoesophageal fistula. It was diagnosed with bronchoscopy and CT We performed tracheal repair with TA 60mm stapler and esophageal repair by interruted two layer suture with 410 vicryl and 510 prolene. A flap of sternocleidomastoid muscle was inserted between trachea and esophagus. Postoperative course was uneventful and the result of operation was acceptable by esophagography.

• Tuberculosis and Respiratory Diseases
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• v.51 no.5
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• pp.462-465
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• 2001

Severe cough may contribute to serious complications such as pneumothorax, pneumomediastinum, rib fracture, subconjunctival hemorrhage, subdural hemorrhage and cough syncope. However abdominal wall hematoma is a rare complication. Because it usually presents with abdomianal pain, abdominal wall hematoma needs to be differentiated from the acute surgical abdomen. A 78-year old woman was admitted with right lower quadrant abdominal pain and a palpable mass for several days. She experienced abdominal pain after violent coughing associated with an upper respiratory tract infection. Abdominal computed tomography revealed an approximately $7{\times}4cm$ sized, ill-defined, soft tissue density lesion in the right lower posterolateral abdominal wall. An abdominal wall hematoma was diagnosed. After admission, she had persistent right lower abdominal pain and an increasing mass. The mass was surgically removed and she was discharged without complications. In summary, when a patient complains of abdominal pain after severe coughing, an abdominal wall hematoma as a differential diagnosis must be considered.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.1
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• pp.2-12
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• 2023

The current study aimed to explore the types and frequencies of uncommon complications associated with third molar extractions based on a scoping review of case reports and case series. The study used an electronic literature search based on PubMed and Embase up to March 31, 2020, with an update performed on October 22, 2021. Any case reports and case series that reported complications associated with third molar extractions were included. The types of complications were grouped and the main symptoms of each type of complication were summarized. A total of 51 types of uncommon complications were identified in 248 patients from 186 studies. Most types of complications were post-operative. In the craniofacial and cervical regions, the most frequent complications included iatrogenic displacement of the molars or root fragments in the craniofacial area, late mandibular fracture, and subcutaneous emphysema. In other regions, the most frequent complications include pneumomediastinum, pneumorrhachis, pneumothorax, and pneumopericardium. Of the patients, 37 patients had life-threatening uncommon complications and 20 patients had long-term/irreversible uncommon complications associated with third molar extractions. In conclusion, a variety of uncommon complications associated with third molar extractions were identified. Most complications occurred in the craniofacial and cervical regions and were mild and transient.