CERVICAL AND MEDIASTINAL EMPHYSEMA SECONDARY TO 3RD MOLAR EXTRACTION

Background. A dramatic case of infected emphysema involving multiple deep cervical and mediastinal fascial planes following surgical extraction of a lower third molar in an otherwise healthy man is presented. Methods. The differential diagnosis and management of this condition are discussed, specifically contrasting it to necrotizing fasciitis. Results. The direct cause of this complication was the use of an air turbine handpiece and air syringe for the tooth extraction. Conclusions. It is advised that air turbine handpieces and air syringes not be used during minor oral surgical procedures. (C) 1994 John Wiley & Sons, Inc.