A 75-year-old man was referred to our hospital with a diagnosis of thyroid carcinoma. CT revealed a tumor in the upper right lobe of the thyroid protruded in the anterior wall of the cervical trachea with bilateral multiple lymph nodes swelling. He underwent total thyroidectomy with excision of the upper trachea and bilateral modified neck dissection. His airway was primarily reconstructed by end-to-end anastomosis. He was ventilated for 7 days in the ICU and extubated on postoperative day (POD) 8. On POD 10, he developed subcutaneous emphysema of the neck extending to the chest. CT revealed a small anastomotic dehiscence and massive subcutaneous emphysema. Because he had no clinical symptoms except for subcutaneous emphysema, we compressed the skin of his neck where was considered at the anastomotic defect by a small triangular pillow made of gauze with tape to stop an air leakage. The subcutaneous emphysema was not extended afterwards and the gauze compression was removed on POD 19. After that he had an uneventful course and was discharged on POD 28. If the patient has no clinical symptoms, the compression of the skin considered at the small anastomotic dehiscence may be useful.