Facial tissue compressed air versus blowing air

Try out PMC Labs and tell us what you think. Learn More. Orbital emphysema is typically a benign condition that occurs following forceful injection of air into the orbital soft tissue spaces. In many cases there is a history of trauma and fracture of an orbital bone, which permits air entry. However, other mechanisms of orbital emphysema have been reported including infection, pulmonary barotrauma, injury from compressed-air hoses, and complications from surgery including dental procedures.
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Barotrauma

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Orbital Emphysema Following Ocular Trauma and Sneezing

Extraction of third molars is the most common surgical procedure performed in oral surgery on a daily basis and, despite surgical skills and expertise, complications may occur. Complications observed during or after third molar removal may include pain, swelling, bleeding, infection, sinus perforation and nerve damage. Fortunately, with a proper management and a good surgical technique, the incidence of such events is low. Subcutaneous emphysema associated with dental extraction occurs when the air from the high-speed dental handpiece is forced into the soft tissue through the reflected flap and invades the adjacent tissues, leading to swelling, crepitus on palpation and occasionally spreading through the tissue spaces of the fascial planes. Although rare, iatrogenic subcutaneous emphysema can have serious and potentially life-threatening consequences. Care should be taken when using air-driven handpieces.
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Orbital Emphysema Following Ocular Trauma and Sneezing

Barotrauma is tissue injury caused by a change in pressure, which compresses or expands gas contained in various body structures. The lungs, gastrointestinal tract, part of the face covered by a face mask, eyes, ears, or sinuses can be affected. Symptoms vary and may include breathing problems or chest pain pulmonary [lung] barotrauma , bloodshot eyes mask barotrauma , vertigo or ear pain ear barotrauma , and facial pain or a bloody nose sinus barotrauma. Measures that can help prevent barotrauma include ascending slowly and breathing during ascent pulmonary barotrauma , blowing out air from the nose into the face mask mask barotrauma , and yawning or swallowing with the nostrils pinched and taking a nasal decongestant before diving sinus and ear barotrauma. See also Overview of Diving Injuries.
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While uncommon, dental providers need to be able to diagnose and treat this potentially fatal complication. According to a number of case reports in the literature, endodontic treatment, surgical extractions, restorative therapy, crown preparations and the use of air abrasion have caused subcutaneous emphysemas. This typically occurs after an extraction in situations in which the patient begins to smoke, cough, exhale forcefully or vomit before any healing has taken place. The first sign of subcutaneous emphysema is the swelling of the overlying soft tissues, which could take place immediately or several hours after the event has occurred. There are signs and symptoms that can guide dental professionals to the correct diagnosis.

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