Don’t Blow It! Extensive Subcutaneous Emphysema of the Neck Caused by Isolated Facial Injuries: A Case Report and Review of the Literature

Makrides, Hannah; Lawton, Luke

doi:10.1016/j.jemermed.2015.12.025

Cited by 8 publications

(8 citation statements)

References 10 publications

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“…In addition, the selected publications contained 61 patients (Table 1). 4–61 One of the selected articles comprised one which was among the 3 aforementioned identified patients of our retrospective search. The overwhelming majority of them were males (87.1%, n = 56) with mean age 34.9 years (median 34.5; 2 months-82 years).…”

Section: Resultsmentioning

confidence: 99%

Pneumomediastinum as a Complication of Oral and Maxillofacial Injuries: Report of 3 Cases and a 50-Year Systematic Review of Case Reports

Papadiochos

Sarivalasis

Chen

et al. 2021

Craniomaxillofacial Trauma & Reconstruction

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Objectives: Pneumomediastinum (PM) secondary to oromaxillofacial trauma (OMF) is a rare but well-described complication/pathologic finding. The aim of this study was twofold: first, to report our experience in treatment of maxillofacial trauma patients with PM, and second, to review the literature regarding the clinical features, severity, course, and management of the aforementioned complication. Material and methods: We retrospectively reviewed the medical records and charts of patients who suffered from maxillofacial trauma and treated in our hospital between September 1, 2013 and September 31, 2017. The inclusion criteria were patients with radiologically confirmed PM. In addition, the electronic databases PubMed, Scopus, and Science Direct were queried for articles reporting PM cases secondary to OMF injuries and published in English, French, and German language. Results: Three cases of PM out of 3,514 cases of craniomaxillofacial trauma were found; there were 3 male patients who presented in our emergency department with the chief complaint of cervicofacial swelling. Literature search isolated 58 selected articles and 63 cases were assessed in total; posttraumatic repeated blowing of nose was proved as most frequent triggering factor among them. Furthermore, the outcomes of review showed that thoracic pain, respiratory distress, and swallowing difficulties were not frequently reported in patients with ME due to facial trauma. Conclusions: Both our experience and the results of systematic literature review indicated that patients with PM due to OMF injuries present mild clinical course. If properly managed, this specific pathologic condition may have no further complications or relative comorbidities. The exact etiology and mechanism of PM in the context of maxillofacial injuries always needs to be identified. Radiographic, laboratory, and endoscopic examinations should be applied to rule out the more serious and frequently diagnosed aerodigestive, thoracic, and abdominal causes of PM.

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Section: Resultsmentioning

confidence: 99%

Pneumomediastinum as a Complication of Oral and Maxillofacial Injuries: Report of 3 Cases and a 50-Year Systematic Review of Case Reports

Papadiochos

Sarivalasis

Chen

et al. 2021

Craniomaxillofacial Trauma & Reconstruction

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“…Elevated white cell count, abdominal tenderness, pleural effusion, and air collection within the pericardium or upper abdominal cavity, encircling the distal esophagus, may signalize perforation of esophagus 28. While the entrapped air is slowly absorbed by surrounding tissues within 2 to 14 days,29 the administration of high concentrations of oxygen accomplishes faster PM resolution by fostering the process of nitrogen washout. Inhalation of nitrous oxide during general anesthesia should be avoided 30.…”

Section: Discussionmentioning

confidence: 99%

“…Inhalation of nitrous oxide during general anesthesia should be avoided 30. The same applies for the high-flow oxygen delivery systems;29 in case of acute maxillofacial trauma or maxillofacial surgery, patients treated by CPAP should withhold its use for a few days 31. Chebel et al32 reported a case where oxygen delivery with CPAP via a face mask resulted in subcutaneous emphysema, PM, and bilateral pneumothoraces shortly after the end of an orthognathic surgery.…”

Section: Discussionmentioning

confidence: 99%

Acute Hyponasality (Closed Rhinolalia) and Craniomaxillofacial Fracture Suggest the Coexistence of Retropharyngeal Emphysema and Pneumomediastinum

Papadiochos

Sarivalasis

Papadogeorgakis

2019

Craniomaxillofacial Trauma & Reconstruction

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Pneumomediastinum (PM) implies an abnormal condition where a collection of free air or gas is entrapped within the fascial planes of mediastinal cavity. It is considered as benign entity, but an uncommonly seen complication of craniofacial injuries. We report a case of a 63-year-old male patient with the presenting sign of closed rhinolalia who was diagnosed with retropharyngeal emphysema and PM due to a linear and nondisplaced fracture of midface. The patient cited multiple efforts of intense nasal blowing shortly after a facial injury by virtue of a motorcycle accident. He was admitted in our clinic for closer observation and further treatment. The use of a face mask for continuous positive airway pressure was temporarily interrupted, and high concentrations of oxygen were delivered via non-rebreather mask. Patient's course was uncomplicated and he was discharged few days later, with almost complete resolution of cervicofacial emphysema and absence of residual PM in follow-up imaging tests. Closed rhinolalia (or any acute alteration of voice) in maxillofacial trauma patients should be recognized, assessed, and considered within the algorithm for PM and retropharyngeal emphysema diagnosis and management. For every single case of cervicofacial emphysema secondary to facial injury, clinicians should maintain suspicion for retropharyngeal emphysema or PM development.

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“…Dental treatment is not the sole cause of surgical emphysema. Often facial fractures with post‐trauma activity, such as nose blowing, have been associated with this complication.…”

Section: Discussionmentioning

confidence: 99%

Child's play – an unforeseen complication of surgical emphysema

et al. 2018

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Surgical emphysema is as an iatrogenic complication whereby air is dispersed within the tissues following an invasive procedure. It is relatively uncommon, however, it has been recognised that dental extractions and the use of air turbine drills can result in this complication. Here, we discuss a case report of a 35-year-old male reattending with extensive surgical emphysema following a seemingly uncomplicated dental extraction, caused by playing with his baby. This case was unusual because no dental air turbine drill was used during the dental extraction, and due to the innocuous patient activity that caused the emphysema. Consideration of the aetiology, prevention and recognition of surgical emphysema are discussed.

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Don’t Blow It! Extensive Subcutaneous Emphysema of the Neck Caused by Isolated Facial Injuries: A Case Report and Review of the Literature

Cited by 8 publications

References 10 publications

Pneumomediastinum as a Complication of Oral and Maxillofacial Injuries: Report of 3 Cases and a 50-Year Systematic Review of Case Reports

Pneumomediastinum as a Complication of Oral and Maxillofacial Injuries: Report of 3 Cases and a 50-Year Systematic Review of Case Reports

Acute Hyponasality (Closed Rhinolalia) and Craniomaxillofacial Fracture Suggest the Coexistence of Retropharyngeal Emphysema and Pneumomediastinum

Child's play – an unforeseen complication of surgical emphysema

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