Cervical and mediastinal emphysema secondary to third molar extraction
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Updated: Nov 6, 2026

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
J W Goodnight1, J A Sercarz, M B Wang
1Division of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, California 90024-1624.
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.
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