Therapeutic Management of Massive Subcutaneous Emphysema Bilateral Pneumothorax and Pneumomediastinum after Anterior Cordectomy for in situ Vocal Cord Carcinoma - Case Report
C.C. Georgescu, C. Margaritescu, I. Osman, M. Stoica, M. Mitroi, V. SurlinClinical case, no. 6, 2014
We present the case of a 70 year-old smoker patient, who wasadmitted in hospital for removal of a tumour located on the leftvocal cord. After direct suspension laryngoscopy (with tumorbiopsy sampling), preliminary histopathological exam revealedan in situ carcinoma. At 2 weeks after histopathologicalconfirmation, the left vocal cord was removed by anteriorapproach, under general anesthesia. In the first 24 hours aftersurgery, the patient presented an ischaemic stroke, with a deepcoma and left hemiplegia, which necessitated mechanicalventilation and specific neurological treatment. Undermechanical ventilation, the patient developed massive subcutaneousemphysema, bilateral pneumothorax and pneumomediastinum,which required tracheostomy and bilateralpleural drainage, in order to limit suddenly installed respiratoryinsufficiency. After an 18-day interval of intensive care therapy,the patient was released at home, considered to be surgicallycured and had a moderate remaining left brachial monoplegia,which was almost totally cured in the next six months.
