Extensive subcutaneous emphysema after use of a high‐speed d
Surgical subcutaneous emphysema is known to be a potential complication of the use of high‐speed air‐driven dental drills (air turbines) and compressed air syringes.

Often, however, we assume that it is just a theoretical risk to be taught to undergraduates that never actually happens in practice.

Published in the journal Oral Surgery, the authors present a case of extensive surgical subcutaneous emphysema secondary to tongue trauma from a high‐speed drill, extending far from the site of air entry.

A 68‐year‐old female was urgently referred by a minor injuries unit to the Oral and Maxillofacial department, due to unresolved bilateral neck swelling and breathlessness. Her medical history included well‐controlled asthma, osteoarthritis and a penicillin allergy.

The day prior to this, the patient sustained trauma to the dorsum of her tongue from a high‐speed dental handpiece during a crown preparation.

There was notable bleeding from the tongue and within 5 minutes she developed marked bilateral facial swelling. This progressed gradually to the neck and chest, but no discomfort was noted.

At this stage, there were no signs of respiratory distress and aside from treatment from the dentist to arrest the tongue haemorrhage, no further medical advice was sought and the patient returned home.

Overnight, however, the patient experienced increasing generalised neck and chest pain, a feeling of breathlessness and worsening dysphonia and so attended the minor injuries unit. An administration of an antihistamine appeared to marginally improve the swelling.

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Dr. S●●●●●●m H●●●●●●r General Medicine
Tracheosteomy would have been a better choice.
Oct 8, 2018Like

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