Pneumomediastinum and subcutaneous emphysema may follow dental extraction

Pneumomediastinum after Third Molar Extraction: Case Report, Physiopathology, and Literature Review

“…However, as we have observed, complications are possible and may be life-threatening [ 10 , 14 ]. Numerous studies have shown that partial resorption occurs on day 4 or 5, and that complete resorption occurs on day 9 or 10 [ 1 – 4 , 8 – 10 , 12 – 18 , 20 – 22 , 24 – 28 ], which occurred in the subject of the current report. The evolution can be monitored by performing X-ray examinations or CT examinations.…”

“…When evaluating a case of swelling after wisdom tooth extraction, it is necessary to make a differential diagnosis of an allergic reaction, hematoma, cellulitis, or subcutaneous emphysema because crepitations rapidly present in the case of subcutaneous emphysema and indicate the correct diagnosis [ 10 , 15 , 22 ]. Patient history will provide information about any previous dental extraction, the protocol used during the extraction, and whether there were increases in intraoral pressure after extraction [ 2 , 3 , 11 ].…”

“…Diagnosis of subcutaneous emphysema is important because, if unnoticed, it can lead to various complications, such as pressure on the orbit, which can cause blindness [9,13], compression of the upper airway that sometimes requires intubation of the patient [1,3,14], and nerve compression (such as that of the recurrent laryngeal nerve) that causes vocal cord paresis [1]. Furthermore, subcutaneous emphysema may extend to the thorax, causing pneumopericardium [19,20] or pneumomediastinum [1, 3, 8, 10-12, [14][15][16][17][19][20][21][22][23][24][25][26][27][28]. Pressurized air can rupture the mediastinal pleura and cause pneumothorax [11,19,26].…”