A case of widespread subcutaneous and mediastinal emphysema following extraction of a mandibular third molar: Changes in emphysema on CT scans

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  • IWAI Toshinori
    Department of Oral and Maxillofacial Surgery, Yokohama City University Medical Center
  • OMURA Susumu
    Department of Oral and Maxillofacial Surgery, Yokohama City University Medical Center
  • OKAMOTO Yoshiyuki
    Department of Oral and Maxillofacial Surgery, Yokohama City University Medical Center
  • SAITO Tomokatu
    Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine
  • UMINO Satoshi
    Department of Oral and Maxillofacial Surgery, Yokohama City University Medical Center
  • FUJITA Kiyohide
    Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine

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Other Title
  • 下顎智歯抜歯時に生じた広範な皮下気腫・縦隔気腫の１例　　ＣＴにおける気腫の変化
  • ショウレイ ホウコク カガク チシ バッシジ ニ ショウジタ コウハン ナ ヒカキシュ ジュウカクキシュ ノ 1レイ CT ニ オケル キシュ ノ ヘンカ
  • CTにおける気腫の変化

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Abstract

Spreading patterns of subcutaneous emphysema and mediastinal emphysema can be detected on computed tomography (CT). As many studies have reported that CT is performed several hoursto several days after the onset of emphysema, CT findings immediately after onset remain unclear. Especially, the time course of emphysema from onset to resolution is poorly understood.<BR>We observed the time course of emphysema by CT, starting immediately after the development of emphysema in the head, neck, and mediastinum. Emphysema was caused by the useof an air turbine handpiece during extraction of a lower impacted third molar. A CT scan obtained immediately after onset showed severe emphysema extending to many head and neck spaces, including the retropharyngeal space to the mediastinum. The next day, emphysema in the parapharygeal space, the retropharyngeal space, and the anterior cervical space rapidlydecreased. After a week, the emphysema had nearly disappeared on the CT scan, except for part of the masticator space.

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