Abstract
This report describes a case of mediastinum emphysema caused by root canal therapy of the lower first molar.A 54-year-old woman presented with swelling of the right submandibular region and dysphagia. She had momentary pain during root canal disinfection with H2O2and NaOCI in the morning. Palpation and ultrasonic echography revealed subcutaneous emphysema extending to the contralateral side. She complained of dyspnea due to airway obstruction. The symptoms disappeared immediately after administration of methylprednisolone sodium succinate. Computed tomography, performed the next day, demonstrated that the emphysema extended to the upper mediastinum. The clinical course was rather good.We need to recognize the possibility that emphysema caused by dental treatment might extend to the mediastinum and lead to respiratory symptoms. Treatment should be performed promptly and adequately in such cases.
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