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Int J Oral Maxillofac Surg. 2000 Oct;29(5):355-7.

Bilateral pneumothorax with extensive subcutaneous emphysema manifested during third molar surgery. A case report.

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Second Department of Oral and Maxillofacial Surgery, Nagasaki University School of Dentistry, Japan.


This report describes a case of bilateral pneumothorax with extensive subcutaneous emphysema in a 45-year-old man that occurred during surgery to extract the left lower third molar, performed with the use of an air turbine dental handpiece. Computed tomographic scanning showed severe subcutaneous emphysema extending bilaterally from the cervicofacial region and the deep anatomic spaces (including the pterygomandibular, parapharyngeal, retropharyngeal, and deep temporal spaces) to the anterior wall of the chest. Furthermore, bilateral pneumothorax and pneumomediastinum were present. In our patient, air dissection was probably caused by pressurized air being forced through the operating site into the surrounding connective tissue.

[Indexed for MEDLINE]

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