A case of subcutaneous emphysema of the face and neck region caused by nose blowing after Le Fort I osteotomy is reported.
A 28-year-old woman presented at our hospital because of masticatory and esthetic impairment. She was given a diagnosis of open bite retrognathia. After preoperative orthodontic treatment, Le Fort I osteotomy and bilateral sagittal split ramus osteotomy were performed. After she strongly blew her nose on the second postoperative day,swelling of the left lower eyelid with difficulty in eye opening occurred.
A computed tomographic (CT) scan revealed low-density areas in the subcutaneous tissue of the face to the anterior neck region, and a diagnosis of subcutaneous emphysema was made.
She was given antibiotics for 8 days to prevent infection. Her clinical course improved, and a CT scan obtained on the 8th day showed no free air remaining in the head and neck region.
We believe that the medical personnel should be fully aware of the risk of subcutaneous emphysema following Le Fort I osteotomy. Patients should be explained the reason why certain actions should be avoided to minimize complications.
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