Pediatr. praxi. 2025;26(4):250-252 | DOI: 10.36290/ped.2025.049

Subcutaneous emphysema and pneumomediastinum after dental procedure

prof. MUDr. Zdeněk Doležel, CSc.1, MUDr. Dana Dostálková1, MUDr. Tamara Pavlíková2, MUDr. Marie Slunská1
1 Pediatrická klinika LF MU a FN Brno
2 Klinika radiologie a nukleární medicíny - Oddělení dětské radiologie, LF MU a FN Brno

Subcutaneous emphysema and pneumomediastinum are rare, but well-known complications of dental procedures. Classically, subcutaneous emphysema occurs within minutes to hours after conclusion of dental procedures especially following intraoral surgical procedures. This emphysema is commonly misdiagnosed as either an allergic reaction or acute post-operative swelling. This case report describes a female toddler who underwent routine dental procedure with use of pharmacologic sedation. She subsequently developed subcutaneous emphysema and pneuomediastinum probably as connection between paradoxical drug reaction and repeated Valsalva maneuver.

Keywords: subcutaneous emphysema, pneumomediastinum, dental procedure, midazolam.

Accepted: August 20, 2025; Published: September 26, 2025  Show citation

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Doležel Z, Dostálková D, Pavlíková T, Slunská M. Subcutaneous emphysema and pneumomediastinum after dental procedure. Pediatr. praxi. 2025;26(4):250-252. doi: 10.36290/ped.2025.049.
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    References

    1. . Damore DT, Dayan PS. Medical causes of pneumomediastinum in children. Clinical Pediatrics. 2001;40(2):87-91. Go to original source... Go to PubMed...
    2. . Chidambaram A, Donekal S. Spontaneous pneumomediastinum and subcutaneous emphysema in a child with unknown aetiology. BMJ Case Rep. 2019;12:e226805. Go to original source... Go to PubMed...
    3. . Mihál M, Michálková K, Wiedermann J, et al. Spontánní pneumomediastinum s podkožním emfyzémem. Pediatr. Pro Praxi. 2005;4:206-208.
    4. . Bowden BK, Bowden SA. Cervicofacial subcutaneous emphysema in a 4-year-old boy. BMJ Case Rep. 2015 https://pumed.ncbi.nlm.nih.gov/26101301. Go to original source... Go to PubMed...
    5. . Boggess WJ, Ronan J, Panchal DDS. Orbital, mediastinal and cervicofacial subcutaneous emphysema after dental rehabilitation in a pediatric patient. Pediatric Dentistry. 2017;39(17):465-467.
    6. . Zaheer S, Srinivasan S, Othman MI. Image challenge: acute chest pain after tooth extraction. Emergency Medicine Journal. 2018;35(5):332. Go to original source... Go to PubMed...
    7. . North L, Sulman C. Subcutaneous emphysema and vocal fold paresis as a complication of a dental procedure. Int J Pediatr Otorhinolaryngol. 2019; 124:76-78. Go to original source... Go to PubMed...
    8. . Moschetta L, Termote K, Ten Tusscher M. Emphysema of the periorbital region and mediastinum in a young child following a dental procedure. J AAPOS. 2021;25(3):190-192. Go to original source... Go to PubMed...
    9. . Ye L-Y, Wang L-F, Gao J-X. Pneumomediastinum and subcutaneous emphysema secondary to dental extraction: two case reports. World J Clin Cases. 2022;10(27): 9904-9910. Go to original source... Go to PubMed...
    10. . Almeida SI, Faustino J, Armindo RD, et al. Subcutaneous facial emphysema secondary to a dental procedure. BMJ Case Rep. 2021;14:e242300. Go to original source... Go to PubMed...
    11. . Mascarenhas RJ. Management of subcutaneous facial emphysema secondary to a class V dental restoration. Clin Case Rep. 2019;7:1025-1030. Go to original source... Go to PubMed...
    12. . Peters M, Shall F, Evrard L. Pneumomediastinum after third molar extraction: case report, physiopathology, and literature review. Case Report in Dentistry. 2023 https://doi.org/10.1155/2023/4562710. Go to original source... Go to PubMed...
    13. . Spille J, Wagner J, Spille DC, et al. Pronounced mediastinal emphysema after restorative treatment of the lower left molar - a case report and systematic review of the literature. Oral and Maxillofacial Sugery. 2023;27:533-541. Go to original source... Go to PubMed...
    14. . Vasakova J, Duskova J, Lunackova J, et al. Midazolam and its effect on vital signs and behavior in children under conscious sedation in dentistry. Physiol Res. 2020;69(Suppl 2): S305-S314. Go to original source... Go to PubMed...
    15. . Shen F, Zhang Q, Xu Y, et al. Effect of intranasal dexmedetomidine or midazolam for premedication on the occurence of respiratory adverse events in children undergoing tonsillectomy and adenoidectomy: a randomized clinical trial. JAMA Netw Open. 2022;5(8):e2225473. Go to original source... Go to PubMed...

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