Airway: surgical emphysema after tracheostomy: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Airway: surgical emphysema after tracheostomy

Sample item

A patient in intensive care develops crepitus over the neck and chest wall a few hours after a tracheostomy. What is a recognised cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Tight closure of the skin around the tube allowing air tracking into the tissue planes

Air escapes from the tracheal incision into the pretracheal fascia and tracks to the neck, mediastinum and chest. Tight suturing of the skin around the tube is a classic contributor. A pneumothorax should be excluded with a chest radiograph.

Option by option

  • A. Hypocalcaemia

    Hypocalcaemia causes tetany, not crepitus.

  • B. Cuff deflation

    Cuff deflation does not cause surgical emphysema.

  • C. Tight closure of the skin around the tube allowing air tracking into the tissue planes (correct)

    Correct. Tight skin closure traps air and promotes spread.

  • D. Excess humidification

    Humidification does not cause air in tissues.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Tight closure of the skin around the tube allowing air tracking into the tissue planes. Air escapes from the tracheal incision into the pretracheal fascia and tracks to the neck, mediastinum and chest.

Why is "Hypocalcaemia" not the answer?

Hypocalcaemia causes tetany, not crepitus.

Why is "Cuff deflation" not the answer?

Cuff deflation does not cause surgical emphysema.

Why is "Excess humidification" not the answer?

Humidification does not cause air in tissues.

What concept does this question test?

It tests Airway: surgical emphysema after tracheostomy in ENT. Tight suturing of the skin around the tube is a classic contributor. A pneumothorax should be excluded with a chest radiograph.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Airway: surgical emphysema after tracheostomy?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.