Pneumomediastinum After Coronectomy

An interesting article titled “Surgical emphysema and pneumomediastinum after coronectomy” appears in the 2015 British Journal of Oral and Maxillofacial Surgery and written by C. Wong and et al. (vol. 53, pp. 763-764). The article describes a case of emphysema and pneumomediastinum occuring in an otherwise healthy 48 year old women after coronectomy of a lower wisdom tooth. This was determined by a chest x-ray after she presented with swelling and impaired eye opening. No surgery was necessary and after staying in the hospital several hours she was discharged. Around a week later the swelling had resolved.

The authors say they do not know of any other cases of pneumomediastinum occuring after coronectomy; however, it is known to occur after wisdom teeth removal. See http://www.teethremoval.com/complications.html where a discussion of this occurs. It appears that an air turbine drill was used in this women’s case and introduced air into the mediastinum through the parapharyngealand retropharyngeal spaces.

The authors state

“Although pneumomediastinum usually resolves spontaneously in 3 to 10 days, potential complications include mediastinitis, cardiac tamponade, obstruction of the airway, simple or tension pneumothorax, and pneumoperitoneum.”

The women appears to have recovered without any problems. In the article a picture of the women is provided shortly after coronectomy and then again 1 week after review. The chest x-ray is also present.

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