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

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


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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Humans
  • Intraoperative Complications / diagnosis*
  • Intraoperative Complications / etiology
  • Male
  • Mandible
  • Mandibular Diseases / complications
  • Mandibular Diseases / surgery
  • Mediastinal Emphysema / diagnosis
  • Mediastinal Emphysema / etiology
  • Middle Aged
  • Molar, Third / surgery*
  • Pneumothorax / diagnosis*
  • Pneumothorax / etiology
  • Radicular Cyst / complications
  • Radicular Cyst / surgery
  • Subcutaneous Emphysema / diagnosis*
  • Subcutaneous Emphysema / etiology
  • Surgical Flaps
  • Tooth Extraction* / methods