Subcutaneous and Periorbital Emphysema Following a Dental Procedure

Abstract

Subcutaneous emphysema following dental procedures is rare. We present the case of a young, healthy woman who was transferred from a dental clinic to our emergency department due to sudden swelling of the left orbit immediately after a dental procedure involving the use of the dental air and water syringe. The diagnosis of subcutaneous facial emphysema was made based on the patient's history, physical examination, and computed tomography imaging. The patient received prophylactic amoxicillin, and the lesion resolved completely in one week. Prompt clinical suspicion and a thorough evaluation of the signs and symptoms, including a detailed clinical history, are crucial for diagnosing subcutaneous emphysema following a dental procedure.

Keywords: air pressure; antibiotic prophylaxis; dental procedures; operative; subcutaneous emphysema.

Figure 1. Facial emphysema

Computed tomography of the neck and head at the time of emergency department presentation: (A) sagittal, (B) coronal, and (C) axial views. Radiolucent air pockets (dark areas) are visible in the subcutaneous tissues of the left midface, extending into the periorbital region. The likely point of entry is the extraction site of the left maxillary first premolar (indicated by the yellow triangle).

Figure 2. Photographs of periocular region

(Top) At the time of emergency department visits. (Bottom) At the follow-up visit one week later.