Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2015 Jun 14;2015(6):rjv068.
doi: 10.1093/jscr/rjv068.

Distinct subcutaneous emphysema following surgical wisdom tooth extraction in a patient suffering from 'Gilles de la Tourette syndrome'

Patrick Tomasetti  1 , Johannes Kuttenberger  1 , Renzo Bassetti  2
Affiliations
Case Reports

Distinct subcutaneous emphysema following surgical wisdom tooth extraction in a patient suffering from 'Gilles de la Tourette syndrome'

Patrick Tomasetti et al. J Surg Case Rep. .

Abstract

Subcutaneous emphysema is a rare complication in oral surgery. In most cases, it resolves spontaneously. However, air might disperse into deeper facial spaces causing life-threatening complications such as compression of the tracheobronchial tree or the development of pneumomediastinum. Moreover, microorganisms might spread from the oral cavity into deeper spaces. Hence, rapid diagnosis of subcutaneous emphysema is important. Characteristic signs are both a shiftable swelling and crepitation. In this case report, a 30-year-old man, suffering from the Gilles de la Tourette Syndrome, with a distinct subcutaneous emphysema after bilateral surgical wisdom tooth extraction is presented. Induced by a specific motor tic, air accumulated from the periorbital through to the parapharyngeal region. Applying a 10-cm-long Redon drainage tube as air valve, 10 days after wisdom teeth extraction, the patient was asymptomatic with complete resolution of the emphysema.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Clinical appearance of the patient with distinct swelling in the periorbital, cheek and supraclavicular region after bilateral wisdom tooth removal.
Figure 2:
Figure 2:
The patient had difficulty to open his eyes.
Figure 3:
Figure 3:
CT scan (coronal section in the first premolar region) showing multiple air inclusions within the facial soft tissue.
Figure 4:
Figure 4:
The frontal CT scan of the head and neck region (section in the retromolar region) illustrates bilaterally trapped air into the soft tissue reaching from the temporal fascia through to the supraclavicular region.
Figure 5:
Figure 5:
Three-dimensional reconstruction of the CT scan showing the trapped air in the head and neck region.
Figure 6:
Figure 6:
The patient after 3 days with tube in place, which served as a valve to avoid air pressure within the oral cavity.
See this image and copyright information in PMC

References

    1. Wakoh M, Saitou C, Kitagawa H, Suga K, Ushioda T, Kuroyanagi K. Computed tomography of emphysema following tooth extraction. Dentomaxillofac Radiol 2000;29:201. - PubMed
    1. McKenzie WS, Rosenberg M. Iatrogenic subcutaneous emphysema of dental and surgical origin: a literature review. J Oral Maxillofac Surg 2009;67:1265. - PubMed
    1. Heyman SN, Babayof I. Emphysematous complications in dentistry, 1960–1993: an illustrative case and review of the literature. Quintessence Int 1995;26:535. - PubMed
    1. Suppa A, Marsili L, Di Stasio F, Berardelli I, Roselli V, Pasquini M et al. . Cortical and brainstem plasticity in Tourette syndrome and obsessive-compulsive disorder. Mov Disord 2014;29:1523. - PubMed
    1. Ganos C, Kuhn S, Kahl U, Schunke O, Feldheim J, Gerloff C et al. . Action inhibition in Tourette syndrome. Mov Disord 2014;29:1532. - PubMed

Publication types

LinkOut - more resources