Self-induced subcutaneous cervicofacial emphysema associated with a defect of external auditory canal

Abstract

This brief clinical report describes a case of the self-induced cervicofacial emphysema. There are many factors that cause cervicofacial subcutaneous emphysema including air-driven handpieces used in dental clinic, maxillofacial trauma, improper chest tubing, neck surgery, or otic surgery. However, there are rare cases of self-induced subcutaneous emphysema due to dehiscence of external auditory canal. In this study, we reported a patient who developed spontaneously subcutaneous emphysema with persistent otitis externa and communication between external auditory canal and temporomandibular joint. A 66-year-old male visited the emergency room with right facial swelling and had crepitus on palpation at right temporal and TMJ area. Enhanced head and neck CT imaging revealed extensive emphysema in masticatory spaces and subcutaneous space of neck area. Cone-beam CT showed a defect in the anterior wall of the external acoustic canal. This canal was occluded using packing of ciprofloxacin soaking gauze. After that, the emphysema was completely disappeared and there was no recurrence at follow up for 3 years after treatment. © 2020 Asian AOMS(+) ASOMP(+) JSOP(+) JSOMS(+) JSOM(+) and JAMI