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http://dx.doi.org/10.14368/jdras.2021.37.3.171

Syncope and pneumomediastinum during the maxillary sinus elevation with an air-syringe: a case report  

Kim, Su Wan (Department of Thoracic and Cardiovascular Surgery, Jeju National Hospital, Jeju National School of Medicine)
Lee, Jonggeun (Department of Thoracic and Cardiovascular Surgery, Jeju National Hospital, Jeju National School of Medicine)
Song, Ji-Young (Department of Dentistry, Jeju National Hospital, Jeju National School of Medicine)
Publication Information
Journal of Dental Rehabilitation and Applied Science / v.37, no.3, 2021 , pp. 171-176 More about this Journal
Abstract
Pneumomediastinum is a very rare and potentially catastrophic complication of dental procedures. Its common causes are tooth extraction, endodontic treatment, and subgingival curettage using handpieces and high-pressure air/water syringes. We present a case of massive pneumomediastinum with subcutaneous emphysema in a 61-year-old female who underwent bone grafting into the maxilla for pretreatment of dental implantation using a syringe. The patient suffered from abrupt severe odynophagia and loss of consciousness. The patient transferred to emergency department and images work-up revealed a pneumomediastinum and subcutaneous emphysema on the entire face and neck. We performed conservative treatments including prophylactic antibiotics, oxygen inhalation, and fasting meals, and then discharge after 7 days uneventfully. The patient's syncope might be resulting from hypotension and pain shock induced by pneumomediastinum with a sudden chest compression. The pneumomediastinum could be resulting from concurrent perforation and massive air infiltration into the maxillary sinus during bone grafting. We suggest that pneumomediastinum needs prompt diagnosis and management because of the risk of airway obstruction when a patient present syncope in the dental room.
Keywords
pneumomediastinum; emphysema; syncope; dental implantation;
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