Clin Exp Otorhinolaryngol.  2008 Mar;1(1):49-51. 10.3342/ceo.2008.1.1.49.

Bilateral Pneumothorax and Pneumomediastinum Following Total Thyroidectomy with Central Neck Dissection

• Lee SW
• Cho SH
• Lee JD
• Lee JY
• Kim SC
• Koh YW

• KMID: 1486037
• DOI: http://doi.org/10.3342/ceo.2008.1.1.49

Abstract

We describe a 60-year-old woman who developed extensive emphysema, bilateral pneumothorax, and pneumomediastinum after total thyroidectomy and central neck dissection with sacrifice of a recurrent laryngeal nerve. In this report, we discuss the possisle etiology of those rare complications.

Keyword

Thyroid; Trachea; Pneumothorax

MeSH Terms

Emphysema
Female
Humans
Mediastinal Emphysema
Middle Aged
Neck
Neck Dissection
Pneumothorax
Recurrent Laryngeal Nerve
Thyroid Gland
Thyroidectomy
Trachea

Figure

• 

  Fig. 1 Intraoperative photographs. (A) The thyroid cancer invading the right recurrent laryngeal nerve directly around the right tracheoesophageal groove (arrow). (B) A small tracheal perforation of the first tracheal ring at the right tracheoesophageal groove (arrow) and the resected right recurrent laryngeal nerve with a hemoclip (arrowhead).

• 

  Fig. 2 Chest radiograph showing extensive subcutaneous emphysema with associated pneumomediastinum (arrowhead) and bilateral pneumothorax (arrow).

Reference

1. Maunder RJ, Pierson DJ, Hudson LD. Subcutaneous and mediastinal emphysema. Pathophysiology, diagnosis, and management. Arch Intern Med. 1984; 7. 144(7):1447–1453. PMID: 6375617.

2. Fewins J, Simpson CB, Miller FR. Complications of thyroid and parathyroid surgery. Otolaryngol Clin North Am. 2003; 2. 36(1):189–206. PMID: 12803016.

3. Aragon SB, Dolwick MF, Buckley S. Pneumomediastinum and subcutaneous cervical emphysema during third molar extraction under general anesthesia. J Oral Maxillofac Surg. 1986; 2. 44(2):141–144. PMID: 3456022.

4. Iacconi P. Inadvertent tracheal perforation during thyroidectomy (Br J Surg 2006; 93: 55-56). Br J Surg. 2006; 6. 93(6):770–771. PMID: 16703648.

5. Gosnell JE, Campbell P, Sidhu S, Sywak M, Reeve TS, Delbridge LW. Inadvertent tracheal perforation during thyroidectomy. Br J Surg. 2006; 1. 93(1):55–56. PMID: 16278924.