Cuccia Antonino Marco, Geraci Agostino
Department of Dental Sciences "G. Messina", Faculty of Surgery, Oncology and Stomatology, University of Palermo, Italy.
Department of Emergency Medicine, Civic Hospital of Palermo, Italy.
Dent Med Probl. 2019 Apr-Jun;56(2):203-207. doi: 10.17219/dmp/108615.
Subcutaneous emphysema (SE) is a rare but potentially life-threatening complication in dental procedures. The development of SE and pneumomediastinum (P) during tooth extraction is an uncommon complication. The roots of the second and third lower molars (and, rarely, of the premolar and first molar) communicate directly with the sublingual and submandibular spaces. Occasionally, after a dental operation, the pressurized air from the drill is forcefully injected into the surrounding subcutaneous tissues proximal to the extraction site in the facial planes. The air might pass through the sublingual and submandibular spaces to the pterygomandibular, parapharyngeal and retropharyngeal spaces, and to the mediastinum. Molar extraction is a common procedure in dental surgery. We report a rare case of extensive cervicofacial SE as well as P, following mandibular second molar extraction with the use of a high-speed dental handpiece, which is specifically designed for restorative treatment. Careful observations of the symptoms and clinical course, and an early initiation of pharmacologic therapy are recommended.
皮下气肿（SE）是牙科手术中一种罕见但可能危及生命的并发症。拔牙过程中发生SE和纵隔气肿（P）是一种不常见的并发症。下颌第二和第三磨牙（很少情况下，前磨牙和第一磨牙）的牙根直接与舌下间隙和下颌下间隙相通。偶尔，牙科手术后，来自牙钻的压缩空气会被强行注入面部平面拔牙部位近端的周围皮下组织。空气可能会通过舌下间隙和下颌下间隙进入翼下颌间隙、咽旁间隙和咽后间隙，并进入纵隔。磨牙拔除是牙科手术中的常见操作。我们报告了一例罕见病例，在使用专门用于修复治疗的高速牙科手机拔除下颌第二磨牙后，出现了广泛的颈面部SE以及P。建议仔细观察症状和临床过程，并尽早开始药物治疗。
