Extraction of subcutaneous emphysema symptoms?

summary

Subcutaneous emphysema is a rare complication in maxillofacial surgery. In most cases, it can subside by itself, but there are still a few cases where the air will spread to the deep tissues of the face, which is life-threatening in serious cases. Therefore, the rapid diagnosis of subcutaneous emphysema is extremely important, which can be judged by facial swelling and twisting. Extraction of subcutaneous emphysema symptoms? Let's talk about it

Extraction of subcutaneous emphysema symptoms?

The patient may have swelling of face and neck soft tissue immediately to several days after the operation. The skin color on the swelling surface is normal without tenderness. There will be twisting sound when palpating the swelling tissue. X-ray film shows diffuse subcutaneous emphysema. CT examination shows a large amount of gas accumulation in the swelling area.

During the extraction of maxillary third molars, the gas can enter into the periorbital tissue flap through the pterygomaxillary space, resulting in subcutaneous emphysema in the periorbital region, and eventually compression of the optic nerve, resulting in decreased vision.

When the gas enters into the parapharyngeal or retropharyngeal space, it may cause serious complications such as mediastinal emphysema or pneumothorax, and eventually oppress the patient's airway and blood vessels, causing dyspnea. The patients with mediastinal emphysema induced by subcutaneous emphysema may have atypical T wave inversion and ST segment deviation. Some patients may also have chest and back pain accompanied by Hamman sign.

matters needing attention

Improved surgical instruments. There are many factors of subcutaneous emphysema caused by tooth extraction, but the most common cause is the use of traditional turbine drill for tooth cutting. When using the pneumatic surgical special cutting mobile phone for tooth cutting, the gas is dispersed around the upper part of the head, and there is no gas ejecting from the working end, which can effectively prevent the gas from directly spraying into the wound and greatly reduce the occurrence of subcutaneous emphysema. In addition, in order to prevent the mucoperiosteal sliding, the tissue flap can be sutured and fixed on the buccal mucosa, or the tissue flap can be pulled open and fixed with a buccal retractor, so as to avoid the formation of subcutaneous emphysema caused by the pressure of intraoral gas into the soft tissue.