Description of Event or Problem · 0
IT WAS REPORTED THROUGH A CLINICAL LITERATURE REVIEW THAT A HEALTHY 51-YEAR-OLD FEMALE WITH A HISTORY OF EUSTACHIAN TUBE DYSFUNCTION PRESENTED ONE DAY POSTOPERATIVE FOLLOWING A BALLOON SINUPLASTY AND BILATERAL ETD WITH SUDDEN ONSET NECK SWELLING, DYSPHAGIA, AND PAIN AFTER AN EPISODE OF SNEEZING. THE PROCEDURE WAS UNCOMPLICATED TECHNICALLY, PER PRIMARY SURGEON¿S REPORT, AND IMMEDIATELY POSTOPERATIVELY THE PATIENT ENDORSED MILD BILATERAL EPISTAXIS BUT NO DISCOMFORT. UPON PHYSICAL EXAMINATION POST OP DAY 1, THE PATIENT PRESENTED WITH ERYTHEMATOUS NECK, FACIAL SWELLING, TRISMUS, AND CREPITUS. FLEXIBLE FIBEROPTIC LARYNGOSCOPY SHOWED MILD BLOODY SECRETIONS BUT NO FRANK MUCOSAL INJURY. A CT SCAN OF THE NECK AND CHEST SHOWED EXTENSIVE SOFT TISSUE EMPHYSEMA CENTERED AT THE LEFT TORUS TUBARIUS, EXTENDING INTO THE IPSILATERAL RETROPHARYNGEAL AND CAROTID SPACES AND INTO THE MEDIASTINUM. THE PATIENT WAS MANAGED CONSERVATIVELY WITH ANTIBIOTIC PROPHYLAXIS AND OBSERVATION BY THE OTOLARYNGOLOGY AND CARDIOTHORACIC SURGERY TEAMS. DAILY CHEST X-RAYS DEMONSTRATED CONTINUED IMPROVEMENT OF THE PNEUMOMEDIASTINUM AND SUBCUTANEOUS EMPHYSEMA. THE PATIENT¿S SYMPTOMS AMELIORATED, AND THE PATIENT WAS DISCHARGED HOME AFTER 3 DAYS ON ORAL ANTIBIOTICS WITH NO FURTHER COMPLICATIONS.