Subcutaneous emphysema is the local tissue swelling caused by the gas entering the subcutaneous tissue through the tissue gap. Although subcutaneous emphysema is usually a nonfatal and self-limited disease, in severe cases, the gas may spread to the neck, mediastinum and chest, resulting in mediastinal emphysema and other serious complications. This article reviews the etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis of subcutaneous emphysema related to dental therapy,and operations that may cause subcutaneous emphysema in stomatology department,as well as the treatment and prognosis of subcutaneous emphysema, with a view to providing some references for dentists.
Humans ; Diagnosis, Differential ; Mediastinal Emphysema/pathology* ; Subcutaneous Emphysema/therapy* ; Neck/pathology* ; Face

Humans ; Mediastinal Emphysema ; Subcutaneous Emphysema ; Thyroidectomy/adverse effects*

A recent achalasia guideline suggests that peroral endoscopic myotomy (POEM) is a safe option for achalasia that is as effective as Heller myotomy. It is recommended that POEM should be performed under general anesthesia. The incidence of adverse events such as bleeding, perforation, and carbon dioxide insufflation-related complications was lower in POEM under endotracheal general anesthesia than in POEM under sedation. Subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumoperitoneum, and accompanying hemodynamic instability can be caused by carbon dioxide insufflation. Treatment of possible physiological changes and adverse events during the POEM procedure from the point of view of anesthesiologists may give endoscopists a new perspective on improving patient safety. The territory of therapeutic endoscopy can be expanded through cooperation with other departments, including anesthesia services. Efforts to understand different perspectives will certainly help not only secure patient safety but also expand the area of treatment.
Anesthesia ; Anesthesia, General ; Carbon Dioxide ; Endoscopy ; Esophageal Achalasia ; Hemodynamics ; Hemorrhage ; Incidence ; Insufflation ; Mediastinal Emphysema ; Patient Safety ; Pneumoperitoneum ; Pneumothorax ; Subcutaneous Emphysema

Tracheostomy is increasingly performed in children for upper airway anomalies. Here, an 18-month-old child (height 84.1 cm, weight 12.5 kg) presented to the emergency department with dyspnea, stridor, and chest retraction. However, exploration of the airways using a bronchoscope failed due to subglottic stenosis. Therefore, a surgical tracheostomy was successfully performed with manual mask ventilation. However, pneumomediastinum was found in the postoperative chest radiograph. Although an oxygen saturation of 99% was initially maintained, oxygen saturation levels dropped, due to sudden dyspnea, after 3 hours. A chest radiograph taken at this time revealed a left tension pneumothorax and small right pneumothorax. Despite a needle thoracostomy, the pneumothorax was aggravated, and cardiac arrest occurred. Cardiopulmonary-cerebral resuscitation was performed, but the patient was declared dead 30 minutes later. This study highlights the fatal complications that can occur in children during tracheostomy. Therefore, close monitoring, immediate suspicion, recognition, and aggressive management may avoid fatal outcomes.
Bronchoscopes ; Child ; Constriction, Pathologic ; Dyspnea ; Emergency Service, Hospital ; Fatal Outcome ; Heart Arrest ; Humans ; Infant ; Masks ; Mediastinal Emphysema ; Oxygen ; Pediatrics ; Pneumothorax ; Radiography, Thoracic ; Respiratory Sounds ; Resuscitation ; Thoracostomy ; Thorax ; Tracheostomy ; Ventilation

Palatine tonsillectomy is a very common procedure and it is relatively safe and has few complications. However, some severe, although rare, complications that can lead a patient to life-threatening status can occur following palatine tonsillectomy. Subcutaneous or mediastinal emphysema is one of the severe complications. We report a case of subcutaneous emphysema and pneumomediastinum after palatine tonsillectomy in a healthy 18-year-old man. After conservative management, subcutaneous emphysema was subsided without other complications.
Adolescent ; Emphysema ; Humans ; Mediastinal Emphysema ; Subcutaneous Emphysema ; Tonsillectomy

BACKGROUND: Subcutaneous emphysema refers to swelling caused by the presence of air or gas in the interstices of loose connective tissue. In the head and neck area, it may follow the fascial planes and is characterized by sudden swelling, crepitus on palpation, infrequent pain, and air emboli on radiography. It usually occurs as a complication in dental treatment. Some reports have described subcutaneous emphysema caused by dental procedures; however, severe emphysema related to peri-implantitis after treatment has not been documented. Accordingly, the current report describes a rare case of subcutaneous cervical emphysema resulting from the use of an air-powder abrasive device to treat peri-implantitis. CASE PRESENTATION: Based on a review of the existing literature and the present case, nine cases of subcutaneous emphysema due to air-powder abrasive device have been reported. In most cases, the emphysema resolved over time after treatment with prophylactic antibiotics; among these, two were related to peri-implantitis management. CONCLUSION: Considering the frequent use of air-powder abrasive devices to treat peri-implantitis, the potential risk of iatrogenic emphysema related to this procedure needs to be addressed more extensively.
Anti-Bacterial Agents ; Connective Tissue ; Emphysema ; Head ; Mediastinal Emphysema ; Neck ; Palpation ; Peri-Implantitis ; Radiography ; Subcutaneous Emphysema

Subcutaneous emphysema is a rare complication of maxillofacial and dental surgery, and may be life-threatening because it can rapidly spread to the scalp, neck, and chest. We report a case of severe subcutaneous emphysema with pneumomediastinum during restorative dentistry in a child with difficulty in communication. The patient was hospitalized for conservative treatment and discharged after complete recovery as a result of timely diagnosis and treatment. Dentists and pediatricians should be aware of potential subcutaneous emphysema during dental treatment, with careful monitoring to ensure prompt diagnosis and treatment.
Child ; Dentistry ; Dentists ; Diagnosis ; Humans ; Mediastinal Emphysema ; Neck ; Oral Surgical Procedures ; Pediatrics ; Scalp ; Subcutaneous Emphysema ; Thorax ; Tooth Extraction

The most common cause of esophageal foreign bodies in adults is meat in Western countries and fish bones in Asian countries, including Korea. Although most ingested foreign bodies pass spontaneously through the esophagus without any clinical sequelae, some sharp foreign bodies, such as fish bones embedded in the esophagus, require treatment. Endoscopic management is the first choice in the treatment of esophageal foreign bodies because it is quite safe and effective. Major complications occur as a result of esophageal perforation; in particular, sharp foreign bodies, such as fish bones, are more likely to cause perforation. Complications include mediastinitis, paraesophageal abscess, pneumomediastinum, subcutaneous emphysema, pneumothorax, tracheoesophagal fistula, aortoesophageal fistula, aspiration, and asphyxia. Unnecessary delays should be avoided in endoscopic intervention for esophageal foreign bodies to prevent complications.
Abscess ; Adult ; Asian Continental Ancestry Group ; Asphyxia ; Esophageal Perforation ; Esophagus ; Fistula ; Foreign Bodies* ; Humans ; Korea ; Meat ; Mediastinal Emphysema ; Mediastinitis ; Pneumothorax ; Subcutaneous Emphysema

No abstract available.
Diabetic Ketoacidosis* ; Humans ; Mediastinal Emphysema* ; Vomiting*

OBJECTIVES: The objective of this study was to analyze 11 cases of subcutaneous emphysema associated with dental procedures from a single hospital and discuss approaches for accurate diagnosis and treatment of the condition. MATERIALS AND METHODS: The medical records of 11 patients who were treated for subcutaneous emphysema related to dental procedures between January 2009 and April 2017 were analyzed retrospectively. Patients with subcutaneous emphysema within the facial area or that spread to the neck and beyond, including the facial region, were assigned to two groups and compared in terms of age, sex, and durations of antibiotic use, hospitalization, and follow-up until improvement. The correlation between location of the origin tooth and range of emphysema spread was analyzed. RESULTS: The average durations of antibiotic use during conservative treatment and follow-up until improvement were 8.55 days (standard deviation [SD], 4.46 days) and 1.82 weeks (SD, 1.19 weeks), respectively. There was no intergroup difference in duration of antibiotic use (P=0.329) or follow-up (P=0.931). Subcutaneous emphysema was more common after dental procedures involving the maxilla or posterior region than after those involving the mandible or anterior region. There was no significant difference in air distribution according to location of the air orifice (maxilla, mandible, or both; P=0.106). CONCLUSION: Upon adequate conservative treatment accompanied by prophylactic antibiotic treatment considering the risk of infection, patients showed signs of improvement within a few days or weeks. There was no significant difference in treatment period between patients with subcutaneous emphysema localized to the facial region and those with subcutaneous emphysema spreading to the neck or beyond. These findings need to be confirmed by analysis of additional cases.
Dental Care ; Diagnosis ; Emphysema ; Follow-Up Studies ; Hospitalization ; Humans ; Iatrogenic Disease ; Mandible ; Maxilla ; Mediastinal Emphysema ; Medical Records ; Neck ; Retrospective Studies ; Subcutaneous Emphysema* ; Tooth