@article{oai:niigata-u.repo.nii.ac.jp:02000547, author = {野池, 淳一 and Noike, Jun-ichi and 横井, 啓 and Yokoi, Kei and 酒井, 洋徳 and Sakai, Hironori and 栗田, 浩 and Kurita, Hiroshi}, issue = {1}, journal = {新潟歯学会雑誌}, month = {Jul}, note = {Subcutaneous emphysema associated with maxillary fracture is not a rare condition, but it may be a life-threatening complication if the air spread into the retropharyngeal space and even more the mediastinum. We report a case of cervico-facial subcutaneous emphysema associated with maxillary fracture. A 45-year-old male was referred to our hospital seeking for the intensive treatment of maxillary fracture and subcutaneous emphysema. Clinical examination revealed marked swelling and crepitus on palpation from the face to the neck. Computed tomography scan demonstrated subcutaneous emphysema spread through the face to the inferior neck region and fractures of the anterior and lateral walls of bilateral maxillary sinus. Diagnosis of subcutaneous emphysema and maxillary fracture were definitive. It was supposed that the air have been entered into the subcutaneous tissue via the fracture when the patient blew one's nose hardly. The patient was intubated with intravenous sedation. Maxillary fracture was treated conservatively and the patient was carefully observed with intravenous antibiotics to prevent further extension and infection. Complete resolution of subcutaneous emphysema was confirmed 3 days after the injury. We medical workers should have accurate knowledge of the subcutaneous emphysema associated with facial trauma because there are many important points of prevention and countermeasure for it., 上顎骨骨折に関連して皮下気腫を生じることはまれではないが,空気が咽後間隙や縦隔にまで及ぶと致命的な合併症となり得る。上顎骨骨折に関連した顔面・頸部皮下気腫の1例を報告する。患者は45歳の男性で,上顎骨骨折および皮下気腫の治療目的に当院を受診した。臨床診査にて顔面から頸部に著明な腫脹および触診時の捻髪音を認めた。CT検査では顔面から下頸部に及ぶ皮下気腫および,両側上顎洞前壁および側壁に骨折を認めた。皮下気腫および上顎骨骨折と診断した。空気は患者が強く擤鼻した際に骨折部を経由して皮下組織に侵入したものと思われた。静脈内鎮静下に挿管管理を行った。上顎骨骨折に対しては保存的治療を行い,皮下気腫の増大や感染予防のため,抗菌薬の静脈内投与を行いながら慎重に経過観察した。受傷3日後に皮下気腫は完全に消失した。顔面外傷に関連した皮下気腫の予防や対処については重要な事項が多く,われわれ医療従事者は正しい知識をもつ必要がある。}, pages = {33--37}, title = {上顎骨骨折に併発し頸部にまで進展した皮下気腫の1例}, volume = {46}, year = {2016} }