A case of subcutaneous and mediastinal emphysema during extraction of an impacted lower third molar

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  • DOHI Akihiro
    Department of Oral and Maxillofacial Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University
  • HARADA Kiyoshi
    Department of Oral and Maxillofacial Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi Section of Maxillofacial Surgery, Department of Maxillofacial/Neck Reconstruction, Graduate School of Medical and Dental Sciences, University of Tokyo Medical and Dental University
  • HIGUCHI Masatoshi
    Department of Oral and Maxillofacial Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi
  • NAKANO Yoshio
    Department of Oral and Maxillofacial Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi
  • KUSAMA Mikio
    Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University

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Other Title
  • 下顎水平埋伏智歯抜歯時に生じた皮下・縦隔気腫の1例
  • カガク スイヘイ マイフク チシ バッシジ ニ ショウジタ ヒカ ・ ジュウカクキシュ ノ 1レイ

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Abstract

A case of subcutaneous and mediastinal emphysema during extraction of an impacted lower third molar is reported. The patient was a 24-year-old woman, who underwent molar extraction under local anesthesia. During the procedure, the patient complained of a slight sore throat, but the extraction was finished with short breaks. After the extraction, the face towel was removed, and it was found that her left eyelid, left cheek, bilateral submandibular regions, and left supraclavicular fossa were red and swollen. A pleural friction rub could be felt in the supraclavicular fossa, and she complained of respiratory discomfort. A computed tomographic scan revealed aerodermectasia from the left temporal region to the bilateral cervical region, as well as mediastinal emphysema extending to the pericardium. The patient was hospitalized and given a drip intravenous infusion of antibiotics. She made satisfactory progress and recovered on day 11. It is very important to consider the possibility of emphysema in such cases and to know how to treat it appropriately.

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