Spontaneous pneumomediastinum and cervical subcutaneous emphysema have been well documented. They occur as a result of increased alveolar pressure sufficient to cause rupture of the alveolar wall and dissection of air along interstitial spaces to the mediastinum and thence along fascial planes to the neck. Occurrence has been reported with asthma, measles, laryngotracheobronchitis, and isolated Valsalva maneuvers. The condition is generally benign and self-limiting and usually requires treatment only for the primary respiratory disease. However, there may be life-threatening complications that require specific surgical management. These patients should be followed closely so that sequelae may be recognized early and appropriate treatment instituted.
Steffey WR, Cohn AM. Spontaneous Subcutaneous Emphysema of the Head, Neck, and Mediastinum. Arch Otolaryngol. 1974;100(1):32–35. doi:10.1001/archotol.1974.00780040036007
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