MULTIPLE CERVICAL SPACES’ SECONDARY EMPHYSEMA CAUSED BY A MANDIBULAR ANGLE FRACTURE FROM ASSAULT, REPORT OF A CASE.

Abstract

Objectives To present a case of subcutaneous cervicofacial emphysema of a patient with a closed mandibular angle fracture after interpersonal violence. Case Report A 36-year-old male was transferred from a regional hospital after a referred interpersonal violence incident. The patient sustained a fracture of the left mandibular angle, as well as a right clavicular fracture, which was treated conservatively by the referring hospital. As depicted by the CT scan, a large emphysema involving the buccal, submandibular, pterygomasseterial and lateral pharyngeal spaces of the left side. Clinically the patient had a positive Hamman’s sign. An open reduction was decided with internal rigid fixation. The postoperative course was uneventful. Conclusions Cervicofacial emphysema, despite not unusual in fractures involving the midface, due to communication with the paranasal sinuses, is a rather rare complication of mandibular fractures. Proper clinical and imaging examination is required to exclude expansion of the air to the mediastinum, which can be a life-threatening complication.