J Endocr Surg.  2021 Mar;21(1):1-12. 10.16956/jes.2021.21.1.1.

Cervical Pneumatocele as Delayed Manifestation of Tracheal Injury after Thyroidectomy: Case Series and Literature Review

  • 1Breast and Endocrine Surgery Unit, Department of Surgery, Hospital Putrajaya, Putrajaya, Malaysia
  • 2Department of Otorhinolaryngology, Hospital Putrajaya, Putrajaya, Malaysia


Delayed manifestation of surgical emphysema as cervical pneumatocele post thyroid surgery is rare and unexpected that which needs to be managed appropriately. Herein we report three cases of delayed tracheal injury presenting with persistent subcutaneous emphysema, without acute respiratory distress. All three cases were managed surgically. Possible risk factors were discussed alongside hypotheses on the mechanisms of delayed tracheal injury and recommendations to prevent such complications. The management algorithm was summarized after the literature review. While surgical management is definitive, the nonsurgical approach can also be a reasonable option, but requires a longer hospital stay.


Thyroidectomy; Complications; Subcutaneous emphysema; Tracheal injury
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