Tension Pneumomediastinum associated with operations on the neck
In 1884 Champneys reported 82 cases of pneumomediastinum in association with tracheotomy operatipns. Since that time there have been reports from time to time on this condition, but it is one of comparative rarity and its incidence is apt to be forgotten by both surgeons and anaesthetists. Prompt action, when it arises, can. be a life-saving measure. Matthew Spence1 reports a fatal case associated with .positive-pressure anaesthesia in which pressure of over 20 mm. Hg was momentarily applied inadvertently. The mechanism in this type of case, however, is not the same as that associated with neck operations, although bilateral tension-pneumothorax may be the result in either case.
Bowden and Schweizer2 in their· admirable article discuss both types at length.