Iatrogenic subcutaneous emphysema and pneumomediastinum following a high‐speed air drill dental treatment procedure

Nishimura, Takeshi; Sawai, Tatsuo; Kadoi, Kanenori; Yamada, Taihei; Yoshie, Norichika; Ueda, Takahiro; Nakao, Atsunori; Kotani, Joji

doi:10.1002/ams2.109

Cited by 12 publications

(9 citation statements)

References 10 publications

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“…When the impairment of the intraoral barrier creates a path that the air can follow, the effect of the high pressure can easily pass through this air-forming defect. [5] Compressed air is believed to reach the dento-alveolar membrane, which is damaged during the procedure, and then the neck and mediastinum through sublingual and retropharyngeal cavities. [4,6] The use of a HSATD during tooth extraction is not a routine practice and HSATD is used in case of cleaning the remaining debris after tooth breakage, as in our case.…”

Section: Discussionmentioning

confidence: 99%

A rare cause of pneumomediastinum and subcutaneous emphysema: Tooth extraction

Işık¹

2020

Turk Gogus Kalp Dama

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Pnömomediastinum mediastinal yapılar arasında serbest havanın varlığı olarak tanımlanır. Olguların çoğu spontan şekilde veya travmatik nedenlerle ortaya çıksa da dental işlemlerden sonra da nadiren görülebilir. Dental işlemler sırasında yüksek hızlı hava türbini matkabı kullanımının mediastinal amfizeme neden olabileceği düşünülmektedir. Yüksek basınçlı hava bozulmuş dento-alveolar membrandan başlayarak yumuşak dokuları diseke eder ve mediastene ulaşır. Kontamine sıvı ve hava intraoral bariyerin bozulmasından sonra mediastene ulaşabilir ve son derece ölümcül desenden mediastinite yol açabilir. Bu yazıda, yüksek hızlı hava türbininin kullanıldığı diş çekimi sonrası pnömomediastinum gelişen 53 yaşında bir kadın hasta sunuldu.

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Section: Discussionmentioning

confidence: 99%

A rare cause of pneumomediastinum and subcutaneous emphysema: Tooth extraction

Işık¹

2020

Turk Gogus Kalp Dama

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“…Patients with pneumomediastinum can have a harsh voice and may experience dyspnea and respiratory distress. A friction rub during systole can be occasionally heard on cardiac auscultation (Hamman's sign) [8,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment in mild to moderate cases should consist of observation and reassurance. Prophylactic antibiotic therapy reduces the risk of secondary infection and severe complications such as mediastinitis [8,12]. In severe cases, immediate medical attention is needed and securing the airway has the highest priority.…”

Section: Discussionmentioning

confidence: 99%

Cervicofacial subcutaneous emphysema and pneumomediastinum secondary to dental treatment in a young man

Rad

Chan

Ahmed

2019

Respiratory Medicine Case Reports

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The occurrence of cervicofacial subcutaneous emphysema and pneumomediastinum is very rare but can be potentially life-threatening. These complications can happen during or after bronchoscopic or dental procedures, esophageal rupture or perforation, infections involving the head and neck and alveolar rupture in the setting of an inciting event such as asthma. The symptoms can appear promptly after the inciting event, but can also be delayed or do not reach maximal intensity for hours. Cervicofacial subcutaneous emphysema usually occurs during or within minutes to hours after dental treatment and can be easily misdiagnosed as post-procedure swelling or an allergic reaction. We report a 36-year-old male who underwent dental treatment for a fractured left lower molar tooth and subsequently developed extensive subcutaneous emphysema and pneumomediastinum. The purpose of this report is to bring attention to the fact that obtaining an accurate diagnosis for this condition is very important and management in a timely manner can prevent serious complications.

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“…(2014) [ 21 ] 13/M RDP / 36 HS Immediate CT /+ – 1 day / - Nishimura & al. (2015) [ 22 ] 68/M RDP /? HS 1 day XR + CT / + N N/A / antibiotics Picard & al.…”

Section: Literature Reviewmentioning

confidence: 99%

Cervicofacial and mediastinal emphysema following minor dental procedure: A case report and review of the literature

Busuladzic

Patry

Fradet

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

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Background: Subcutaneous cervical emphysema is a clinical sign associated with many conditions, including laryngotracheal trauma, pneumothorax and necrotizing deep tissue infections. Case presentation: We discuss a case of a 76-year-old man presenting with extensive cervical emphysema a few hours after a minor dental filling procedure. The CT-scan revealed a significant amount of air within the cervical and mediastinal spaces, reaching lobar bronchi. Vitals were within normal values Bloodwork demonstrated an elevation of creatinine kinase (3718; normal < 150) and mild leukocytosis (WBC = 11.6). We decided to proceed to an urgent cervical exploration to exclude necrotizing fasciitis. This revealed air but no tissue necrosis nor abnormal fluid. The patient improved clinically and was discharged two days later with oral antibiotics. Although cervicofacial subcutaneous emphysema following dental procedures has been reported, it is usually less extensive and involving more invasive procedures using air-driven handpieces. Conclusion: As an otolaryngologist confronted with extensive subcutaneous emphysema following a potential entry route for an aggressive infection, given the seriousness of this diagnosis, the decision of whether or not to perform a diagnostic surgical exploration should remain.

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Iatrogenic subcutaneous emphysema and pneumomediastinum following a high‐speed air drill dental treatment procedure

Cited by 12 publications

References 10 publications

A rare cause of pneumomediastinum and subcutaneous emphysema: Tooth extraction

A rare cause of pneumomediastinum and subcutaneous emphysema: Tooth extraction

Cervicofacial subcutaneous emphysema and pneumomediastinum secondary to dental treatment in a young man

Cervicofacial and mediastinal emphysema following minor dental procedure: A case report and review of the literature

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