Abstract
A case of subcutaneous and mediastinal emphysema during extraction of an impacted lower third molar is reported. The patient was a 24-year-old woman, who underwent molar extraction under local anesthesia. During the procedure, the patient complained of a slight sore throat, but the extraction was finished with short breaks. After the extraction, the face towel was removed, and it was found that her left eyelid, left cheek, bilateral submandibular regions, and left supraclavicular fossa were red and swollen. A pleural friction rub could be felt in the supraclavicular fossa, and she complained of respiratory discomfort. A computed tomographic scan revealed aerodermectasia from the left temporal region to the bilateral cervical region, as well as mediastinal emphysema extending to the pericardium. The patient was hospitalized and given a drip intravenous infusion of antibiotics. She made satisfactory progress and recovered on day 11. It is very important to consider the possibility of emphysema in such cases and to know how to treat it appropriately.
