IMAGES IN MEDICINE
Rare complications of surgical emphysema and pneumomediastinum occurring post dental extraction
Correspondence to:
Correspondence to Dr T L Samuels, Department of Medicine, The Princess Royal Hospital, Lewes Road, Haywards Heath RH16 4EX, UK; dr_tsamuels@tiscali.co.uk
Keywords: dental; emphysema; extraction; pneumomediastinum; surgical
| The first 150 words of the full text of this article appear below. |
A 20-year-old woman presented with painful left sided facial swelling and discomfort following dental extraction for a left lower molar tooth that required local anaesthetic and an air turbine drill. The patient was initially diagnosed as experiencing an allergic reaction to the anaesthetic used. The discomfort began in the left side of her face postoperatively, radiating down her neck and to her sternum. There were no clinical signs of cardiorespiratory distress. Swelling was noted down the left side of her face and extended to the submandibular region bilaterally and left supraclavicular fossa. Crepitus was demonstrated by palpation of the left side of her neck. An anteroposterior facial view (fig 1) and posteroanterior chest radiographs (fig 2) revealed pronounced surgical emphysema in the soft tissues of the face, neck and chest, along with a small pneumomediastinum. Prophylactic intravenous antibiotics, steroids and analgesia were prescribed and the patient
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