Cervical and mediastinal emphysema secondary to third molar extraction

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.