Cervical subcutaneous emphysema is typically caused by air in the upper aerodigestive tract expanding into the retropharyngeal space and the mediastinum. Among such cases, spontaneous subcutaneous emphysema is a rare disease that can occur without clear external injuries and often does not require medical or surgical intervention. Predisposing factors include repeated coughing and vomiting. The condition is presumed to be caused by an increase in intrathoracic and pulmonary alveolar pressure.1 However, we report herein the first case, to our knowledge, of cervical subcutaneous emphysema in the context of an anatomic deficit in the nasopharynx diagnosed by nasal endoscopy and a review of the literature.
Ko HS, Han KY, Kim JH, Kim JY, Shim BS, Song YJ. Spontaneous Cervical Emphysema With Nasopharyngeal Fistula. Arch Otolaryngol Head Neck Surg. 2010;136(4):404-406. doi:10.1001/archoto.2010.37