Cervicofacial Subcutaneous Emphysema and Pneumomediastinum after a Dental Procedure

ABSTRACT

The occurrences of subcutaneous emphysema or pneumomediastinum after a dental procedure are rare, but they are potentially life-threatening complications. These complications are reported to occur mainly in patients after dental procedures on the third molar, in particular during mandibular extractions and treatment on the right side. A 22-yearold woman visited the emergency department with neck swelling and chest pain after a right lower third molar extraction. She had a subcutaneous emphysema on the face and neck. Her chest x-ray and computed tomography of the chest showed a pneumomediastinum. She was discharged 6 days later without serious complications. Many cases of subcutaneous emphysema are of limited severity, resulting in minor, localized swelling, and require nothing more than observation and reassurance. However, early recognition of these problems is essential in preventing lifethreatening complications such as airway obstruction, mediastinitis, deep neck infection, and cardiac failure. We review the pathophysiology and clinical course of this disease.