Cervicofacial and mediastinal emphysema due to a dental proc
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The etiologies of subcutaneous emphysema are numerous, and the syndrome results in considerable alarm in both the patient and the clinician. Cervicofacial and mediastinal emphysema as a complication of dental procedures can lead to severe infection of the surrounding tissues (Ludwig's angina, Lemierre's disease mediastinitis, etc.) asphyxiation or air embolism.Anatomically, the neck fascia compartmentalizes the structures within the neck. These layers of tough fascia define routes through which air or infection can spread.The spaces between the deep cervical fascial planes of the head and neck are contiguous with the mediastinal space. Therefore, air or infection can easily spread from the head and neck into the mediastinum.We report on a healthy 28-year-old woman who was sent to the emergency department (ED) by her dentist for the evaluation of a possible allergic reaction which began toward the end of a dental procedure. On the day of presentation, the patient had a composite filling for caries on the buccal aspect of the first maxillary molar (tooth #14), second mandibular premolar (#20), and first mandibular molar (#21) after routine local anaesthesia with 2% lidocaine. The dentist used a standard, high-speed dental drill for the procedure and did not report any equipment malfunctions...

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