歯科治療中に発症した縦隔気腫の1例

A Case of Subcutaneous ana Mediastinal Emphysema Following the Extraction of Mandibular Third Molor

　はじめに

　顔面や頸部の皮下気腫は頭頸部手術後にみられることがあるが，日常の診療においてはあまりみられない^1〜4）。しかし，それらは顔面や頸部の腫脹を呈するため，原因によらず耳鼻咽喉科を受診することが多い。

　今回われわれは，某歯科医院で左下顎智歯の抜歯時に皮下気腫と縦隔気腫を発症した1症例を経験したので，若干の文献的考察を加えて報告する。

A 24-year-old women developed subcutaneous and mediastinal emphysema caused by the use of a dental air-turbine drill during an unilateral mandibuler thirdmoler extraction. The diagnosis of emphysema was made from clinical symtoms and typical radiographs. Management and treatment consisted of a bed rest and compression, and intravenous injection of antibiotics for prophalaxis. On the 14^th day, emphysema disappeared on CT.

Subcutaneous emphysema caused by dental treatment has been known to dentists but unknown to otorhino-laryngolosists. The most important point is that if em-physema is restricted to the face and neck, one should suspect mediastinal emphysema.