수면무호흡 환자에서의 외측 인두성형술 후 발생한 피하기종

Abstract

Lateral pharyngoplasty is a surgical option for treatment of obstructive sleep apnea (OSA). Here, we present a case involving a40-year-old healthy man who underwent surgery, including lateral pharyngoplasty and robotic tongue base resection, for OSA. There were no intraoperative or immediate postoperative complications. However, on postoperative day 3, the patient presentedwith swelling in the temporal and buccal areas and was diagnosed with subcutaneous emphysema, later confirmed by computedtomography. The patient was carefully monitored under conservative care and discharged without complications. Althoughsubcutaneous emphysema following tonsillectomy is a rare complication and usually resolves with conservative management,in certain cases, it might require surgical intervention. Lateral pharyngoplasty involves tonsillectomy and additional incisionalong the tonsillar fossa, which makes it susceptible to pharyngeal wall defects and, consequently, subcutaneous emphysema. Additionally, lateral pharyngoplasty and robotic tongue base resection cause pain and might thus contribute to the increase inintrapharyngeal pressure, which might aggravate subcutaneous emphysema. Lateral pharyngoplasty should be performed withmeticulous dissection of the superior pharyngeal constrictor muscle. Healthcare providers should be aware of these complicationsand, upon suspicion of the same, place the patient under close observation to prevent life-threatening situations.