Ye LY, Wang LF, Gao JX. Pneumomediastinum and subcutaneous emphysema secondary to dental extraction: Two case reports. World J Clin Cases 2022; 10(27): 9904-9910 [PMID: 36186210 DOI: 10.12998/wjcc.v10.i27.9904]
Corresponding Author of This Article
Jin-Xing Gao, MD, Professor, Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (The Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. gaojinxing78@163.com
Research Domain of This Article
Emergency Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 26, 2022; 10(27): 9904-9910 Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9904
Pneumomediastinum and subcutaneous emphysema secondary to dental extraction: Two case reports
Ling-Yun Ye, Lian-Fei Wang, Jin-Xing Gao
Ling-Yun Ye, Jin-Xing Gao, Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People’s Hospital (The Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
Lian-Fei Wang, Department of Stomatology, The First People's Hospital of Hangzhou Lin An District, Hangzhou 311300, Zhejiang Province, China
Author contributions: Gao JX was responsible for surgery and medicine; Ye LY and Wang LF were responsible for collecting data and writing the paper; All authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Xing Gao, MD, Professor, Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (The Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. gaojinxing78@163.com
Received: May 12, 2022 Peer-review started: May 12, 2022 First decision: June 16, 2022 Revised: June 22, 2022 Accepted: August 21, 2022 Article in press: August 21, 2022 Published online: September 26, 2022
Abstract
BACKGROUND
Dental extraction is a common operation in oral surgery and is usually accompanied by pain, swelling, and local infection. The application of high-speed air turbines increases the comfort of alveolar surgery and makes it more minimally-invasive. However, high-speed gas can enter the subcutaneous tissue of the face and neck or even the chest and mediastinum, which is a serious iatrogenic complication.
CASE SUMMARY
We describe two cases of severe subcutaneous and mediastinal emphysema caused by high-speed turbine splitting during dental extraction. The first case involved a 34-year-old man who complained of swelling of the face, mild chest tightness, and chest pain after dental extraction. Computed tomography (CT) scan showed a large amount of gas in the neck, chest wall, and mediastinum. The second case involved a 54-year-old woman who complained of swelling and pain of the neck after dental extraction. CT showed a large amount of gas collected in the neck and mediastinum. Both of them used high-speed turbine splitting during dental extraction.
CONCLUSION
High-speed turbine splitting during dental extraction may lead to severe subcutaneous and mediastinal emphysema. Dentists should carefully operate to avoid emphysema. If emphysema occurs, CT can be used to improve the diagnosis. The patient should be informed, and the complications dealt with carefully.
Core Tip: Facial and neck emphysema, especially with mediastinal emphysema, is rare complication in dental treatment. Iatrogenic subcutaneous emphysema is associated with the use of high-speed turbines. Here, we reported two cases of pneumomediastinum and subcutaneous emphysema secondary to dental extraction. We want to caution the dentists to be carefully to avoid the emphysema in the dental operate.
