• Leh-Kiong Huon, Yen-Liang Chang, Pa-Chun Wang, and Po-Yueh Chen.
• Department of Otolaryngology, Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan.
• Otolaryngol Head Neck Surg. 2012 Jan 1;146(1):53-7.

ObjectiveSpontaneous pneumomediastinum (SPM) is a rare disease entity that often manifests localized signs in the head and neck region. The thoracic features of SPM have been well described; however, there is a paucity of information on its otolaryngological characteristics. The authors describe the clinical management among SPM patients having primarily head and neck symptoms.Study DesignCase series with chart review.SettingCathay General Hospital, Taiwan.ResultsThe study included 13 men and 1 woman, with a mean age of 18.8 years (range, 14-29 years). The primary initial symptoms were neck swelling (11), neck pain (10), and odynophagia (9). Neck soft tissue and chest radiography was diagnostic of SPM in all patients. Conservative treatment consisted of bed rest and analgesics, which led to rapid resolution of SPM.ConclusionsSPM is a benign entity that responds well to conservative treatment. The results of our investigation highlight the importance of an ear, nose, and throat (ENT) clinical examination as a guide for diagnosing SPM because of the high percentage of ENT manifestations in the initial clinical profiles. Secondary causes of SPM must be ruled out to avoid an unfavorable outcome.

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