Two Cases of Mediastinal Emphysema Caused by Air Delivery of Dental Devices—A Case Report—

Abstract

The patient 1 was a 66-year-old man. He presented to our emergency department with left facial swelling which developed on the same day after he received dental treatment for the left lower molar teeth. He was admitted to our hospital for follow-up after a CT scan showed emphysema extending from the left cheek to the superior mediastinum. He was discharged on independent gait after rest and antibiotics treatment, and his symptoms have not worsened since then. The patient 2 was a 63-year-old man. He was treated for periodontal disease of the left lower molar teeth, and had swelling and pain in the left buccal region. Due to worsening of symptoms, he presented to our emergency department on the next day. A CT scan showed subcutaneous and mediastinal emphysema from left cheek to bilateral sides of neck, but his symptoms and findings were mild. He was treated with oral antibiotics and sent home. His symptoms have not worsened since then.

Mediastinal emphysema is commonly caused by a trauma or in association with spontaneous pneumothorax, and is widely known to physicians treating respiratory diseases. However, it is not well known that dental treatment is a cause of mediastinal emphysema, and we report these cases with some reviews of the literature.