Subcutaneous facial emphysema and pneumomediastinum after root canal therapy

Abstract

Background: Subcutaneous emphysema and pneumomediastinum is a rare complication after head and neck surgery and very rare complication in dentistry, particulary if it is caused by treatment of a root canal. Most cases resolve spontaneously but life-threatening complications that require emergency intervention are possible. The most common causes of pneumomediastinum in children are trauma, asthma exacerbations and infections. Iatrogenic and spontaneous pneumomediastinum in children is not common. We present a 17 year old female patient with subcutaneous emphysema starting on the face and subsequently extending into the neck and mediastinum following treatment of a tooth root canal. Subcutaneous emphysema resolved in three days and pain as a symptom of pneumomediastinum subsided in one day after oxygen administration and antibiotic treatment. The article also discuses other possible causes of facial emphysema and pneumomediastinum, clinical and radiographic findings associated with this complication and reviews diagnostic consideration and management.Conclusions: Pneumomediastinum is a very rare complication of dental treatment. However, it should be taken into account in case of a tipical clinical presentation.

Keywords

• pneumomediastinum
• symptoms and signs
• diagnosis
• therapy
• subcutaneous facial emphysema
• dentistry