2018 Volume 46 Issue 3 Pages 142-144
Subcutaneous and mediastinal emphysema are complications associated with oral and maxillofacial surgery. A 63-year-old male underwent oral surgery under general anesthesia, and an air turbine drill was used for third molar split and extraction. He postoperatively developed massive subcutaneous emphysema extending from his cheeks and neck to his chest wall. A neck and chest computed tomography examination revealed mediastinal emphysema. Accordingly, the patient was transported to the intensive care unit (ICU) under tracheal tube intubation and was treated with antibiotics. The patient tracheal tube was then extubated 4 hours thereafter. As no further complications were observed, the patient was discharged on postoperative day 5. Most cases of subcutaneous and mediastinal emphysema have been reported to be caused by the extraction of wisdom teeth with mandibular impaction and the use of high-speed dental drills. These factors were likely causes in the presently reported patient as well. When patients are exposed to these risks, anesthesiologists should anticipate possible complications, such as mediastinitis and airway obstruction, and should perform intensive care management as applicable. This report describes a patient who developed extensive subcutaneous and mediastinal emphysema after oral surgery performed under general anesthesia who was subsequently admitted to the ICU.
