Panagiotis Saravakos - Department of Otorhinolaryngology, Head and Neck Surgery, Siloah St. Trudpert Hospital, Pforzheim, Germany.
Margaritis Taxeidis - Department of Otorhinolaryngology, Head and Neck Surgery, Siloah St. Trudpert Hospital, Pforzheim, Germany.
Ioannis Kastanioudakis - Department of Otorhinolaryngology Head and Neck Surgery, University Hospital of Ioannina, Ioannina, Greece.
Oliver Reichel - Department of Otorhinolaryngology, Head and Neck Surgery, Siloah St. Trudpert Hospital, Pforzheim, Germany.

Introduction: Subcutaneous and mediastinal emphysema is a rare complication after tonsillectomy. This case presentation and literature review summarizes the existing literature on this unusual complication.  Materials and Methods: This study presents a case of a 21-year-old man who developed a cervical subcutaneous emphysema 6 days after tonsillectomy, whereby conservative treatment produced spontaneous resolution. A proper analysis of this case also required undertaking a systematic search in MEDLINE/PubMed and SCOPUS electronic databases concerning this rare complication, without language restrictions.  Results: Based on our criteria, we identified 41 reports including 43 individual cases, in which patients were mostly young and equally distributed between the genders (17 males and 22 females, two unknown). The treatment was mainly conservative and consisted of observation and/or antibiotic therapy.   Conclusion: Subcutaneous or mediastinal emphysema is an uncommon complication after tonsillectomy. It is important that clinicians become aware of this rare complication, which requires a close monitoring of the patient.      

Tonsillectomy, Mediastinal Emphysema, Subcutaneous Emphysema