ABSTRACT
Subcutaneous cervical emphysema often appears as a result of surgery or trauma. However, when it occurs spontaneously, the patient may present with clinically impressive and dramatic features. The etiology is related to the rupture of terminal alveoli and dissection of air along the pulmonary vasculature. Exercise may contribute to the process by increases in intrathoracic pressure. Six cases of spontaneous cervical emphysema, all related to SCUBA diving training at a Naval facility, were recently seen at our institution. Proper management entails having a high index of suspicion for diagnosis, and then being able to identify potentially life-threatening complications.
Subject(s)
Emphysema , Mediastinal Emphysema , Neck , Subcutaneous Emphysema , Adult , Diving/adverse effects , Emphysema/diagnosis , Emphysema/etiology , Emphysema/therapy , Humans , Male , Mediastinal Emphysema/diagnosis , Mediastinal Emphysema/etiology , Mediastinal Emphysema/therapy , Subcutaneous Emphysema/diagnosis , Subcutaneous Emphysema/etiology , Subcutaneous Emphysema/therapyABSTRACT
Carcinomas arising in burn scars are uncommon. Of the several hundred cases reported in the world's literature, 30% have been described in the head and neck region. Acute burn scar carcinoma, which occurs within one to two years of injury, is rare, while the chronic type, with an average latency of 35 years from injury to diagnosis, is much more common. Two cases of burn scar carcinoma are presented. Treatment is based on the histologic cell type (usually squamous cell or basal cell), in addition to the clinical stage. Adjuvant radiation therapy can often improve the results obtained with surgical excision alone. Proper initial treatment of burns, with early use of skin grafts, might curb the development of these potentially serious tumors.
