Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital d'Instruction des Armées, boulevard Sainte-Anne de Toulon, BP 600, 83800 Toulon Naval, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2011 Jun;128(3):147-9. doi: 10.1016/j.anorl.2010.12.006. Epub 2011 Mar 9.
Cervical subcutaneous emphysema and pneumomediastinum are often secondary to trauma, surgery or infection. More rarely, they can be spontaneous with no identified cause, but forced Valsalva manoeuvres are a known predisposing factor. Any forced effort with a closed glottis, such as sneezing, can cause rupture of the mucosa leading to the formation of cervical subcutaneous emphysema and pneumomediastinum.
The authors report the case of a 30-year-old man with cervical subcutaneous emphysema complicated by pneumomediastinum due to fistula of the piriform sinus following sneezing while simultaneously obstructing both nostrils.
DISCUSSION/CONCLUSION: Rupture of the mucosa of the piriform sinus is an extremely rare complication of this type of manoeuvre. This condition requires management in hospital due to the risk of infection with cervical cellulitis progressing to mediastinitis. Simultaneously obstructing both nostrils during sneezing is a dangerous manoeuvre that should be avoided.
颈皮下气肿和纵隔气肿常继发于创伤、手术或感染。更罕见的是，它们可能是自发性的，没有明确的原因，但强制瓦氏动作是已知的诱发因素。任何伴有声门关闭的强制用力，如打喷嚏，都可能导致粘膜破裂，导致颈皮下气肿和纵隔气肿的形成。
作者报告了一例 30 岁男性病例，由于同时阻塞两个鼻孔打喷嚏，导致梨状窦瘘，并发颈皮下气肿和纵隔气肿。
讨论/结论：梨状窦粘膜破裂是这种类型的操作的一种极其罕见的并发症。这种情况需要在医院进行治疗，因为存在感染风险，颈蜂窝织炎进展为纵隔炎。同时阻塞两个鼻孔打喷嚏是一种危险的动作，应予以避免。
