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July 1990

Iatrogenic Retropharyngeal Emphysema

Arch Otolaryngol Head Neck Surg. 1990;116(7):864. doi:10.1001/archotol.1990.01870070112022

To the Editor.—I am writing this letter concerning the article by Breznick and Saporito1 on "Iatrogenic Retropharyngeal Emphysema With Impending Airway Obstruction." There is a very simple method of eliminating air in tissue.

Of course, air is 80% nitrogen. Nitrogen is inert. Oxygen is picked up by the bloodstream very rapidly, and the nitrogen remains a problem. Nature abhors spaces and will then begin to fill those spaces with tissue fluids that can become infected quite rapidly. Although nitrogen is inert, it can be eliminated fairly rapidly. This treatment was not mentioned under the "Management Aspects" section of the article.

Because nitrogen is inert, the only way to eliminate nitrogen is to create as large a partial pressure difference between the nitrogen in the tissue and the nitrogen in the blood. Then, according to the general gas laws, the nitrogen gas will flow to the area of lower

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