Self-Induced Subcutaneous Facial Emphysema in a Prisoner: Report of a Case

Abstract

Subcutaneous cervicofacial emphysema is a rare condition that results from various causes. Initially it might be misdiagnosed and managed as other clinical entities, such as angioedema. We report a case of self-induced subcutaneous facial emphysema in a prisoner who sought better living conditions by simulating an emergency.

Where Is the Air Coming From? A Case Report of an Adolescent With Cervicofacial Emphysema

“…Self-induced oral injury with sharp objects followed by Valsalva maneuver to achieve cervicofacial emphysema apparently was common knowledge among South American and European prisoners with the intention of escaping from detention by situation of an emergency. 4,5 We believe the cause of the emphysema in our patient was due to the oral ulcer in the absence of other findings. The absence of chest pain and pneumomediastinum excluded the possibility of spontaneous alveolar rupture, which would have caused air to enter the mediastinum and via tissue spaces in the neck.…”

“…There was no pneumothorax or pneumomediastinum in his chest radiograph and computed tomography (Figs. [4][5][6]. His otolaryngologic examination result including endoscopy was also normal.…”

Cervicofacial emphysema following unilateral external dacryocystorhinostomies: A case report

“…Vision loss may accompany CFE in rare cases of orbital involvement. [ 4 5 6 7 ] Orbital emphysema develops mostly after orbital trauma, but is an extremely rare complication of external DCR. Orbital air entrapment occurs as a result of a communication between the orbit and the nasal sinuses.…”

“…There are many predisposing factors such as trauma, dental procedures, maxillofacial or orbital surgeries, tracheal intubations, pneumomediastinum, and infections that result in cervicofacial subcutaneous emphysema. [ 1 2 3 4 ] Although CFE is generally accepted as a self-limited situation, it may threaten life by airway obstruction due to neck involvement. Moreover, it may cause loss of vision in case of extensive orbital emphysema.…”