Cervical Mediastinal Emphysema

Abstract

John A. Kirchner, MD: Good morning, ladies and gentlemen. Welcome to surgical grand rounds. We have a subject this morning that I think will be of interest to surgeons in general and not just general surgeons. We are going to discuss the subject of cervical mediastinal emphysema under several headings. We will start with the patient who walks into the emergency room with air in the neck, face, and perhaps mediastinum, and consider the diagnosis and management of the problem. We will then proceed to the subject of the usual accumulation of air that develops after trauma or surgery to the neck or larynx and then, finally, consider chest trauma and positive pressure ventilation. Karen Hermansen, MD, will describe the first patient. Dr Hermansen: The patient is a 20-year-old man who was playing hockey when he was struck on the left shoulder by an opponent. Within ten minutes, hyponasal speech