Document Detail

Iatrogenic subcutaneous emphysema of dental and surgical origin: a literature review.
MedLine Citation:
PMID:  19446214     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Subcutaneous emphysema arises when air is forced beneath the tissue, leading to swelling, crepitus on palpation, and potential to spread along the fascial planes. The goal of this literature review is to alert the oral and maxillofacial surgeon to the inciting factors, diagnosis, and management of subcutaneous emphysema. PATIENTS AND METHODS: A comprehensive search of the medical and dental literature from 1993 to 2008 was performed using PubMed, and yielded 32 case reports of subcutaneous emphysema. Only cases associated with dental or surgical procedures were included. Cases of trauma were excluded. RESULTS: Sixteen of the 32 cases were linked to the use of air-driven handpieces. Other cases involved a CO(2) laser, a NO(2) cryomachine, an air abrasive system, endotracheal intubation/ventilation, and patient activities after surgical procedures. Of the cases reviewed, 5 resulted in significant complications after subcutaneous emphysema. CONCLUSION: Although rare, iatrogenic subcutaneous emphysema can have serious and potentially life-threatening effects. Care should be taken when using air-driven handpieces or performing endotracheal intubation/ventilation. Additionally, instructions should be given to patients after procedures violating the epithelium to reduce the incidence of subcutaneous emphysema. When subcutaneous emphysema does arise, it must be quickly diagnosed and properly managed to reduce further complications.
Wm Stuart McKenzie; Morton Rosenberg
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons     Volume:  67     ISSN:  1531-5053     ISO Abbreviation:  J. Oral Maxillofac. Surg.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-18     Completed Date:  2009-06-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8206428     Medline TA:  J Oral Maxillofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1265-8     Citation Subset:  AIM; D; IM    
Tufts University School of Dental Medicine, Boston, MA, USA.
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MeSH Terms
Dental Instruments / adverse effects
Dentistry, Operative*
Iatrogenic Disease*
Intubation, Intratracheal / adverse effects
Oral Surgical Procedures / adverse effects*
Subcutaneous Emphysema / etiology*

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