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Facial subcutaneous emphysema in a patient with connective tissue disorder
  1. Jon Curtis1,
  2. Nicola Rachel Wooles1 and
  3. David Phillips2
  1. 1Otolaryngology, Warwick Hospital, Warwick, UK
  2. 2Warwick Hospital, Warwick, UK
  1. Correspondence to Dr Jon Curtis; joncurtis101{at}


A 47-year-old woman presented to the emergency department with sudden onset of swelling in her face, which had been triggered by blowing her nose. She had no other symptoms, but was known to have Ehlers-Danlos syndrome. A CT confirmed bilateral subcutaneous facial emphysema attributed to a defect in her left nasal cartilage. The condition was managed conservatively with prophylactic antibiotics and self-resolved within 48 hours. Only eight cases of sudden facial subcutaneous emphysema following nose blowing or sneezing have been found in the English literature and this is the first known case in a patient with a connective tissue disorder. In this case, her condition is suspected to have contributed to her presentation and may be underlying in other similar cases.

  • otolaryngology / ENT
  • connective tissue disease
  • dentistry and oral medicine

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  • Contributors JC was the primary author of the case report. NRW assisted in writing the report and collecting all of the necessary information. DP was responsible for clinically managing the patient and conceived the idea for the case report. He also reviewed and provided edits on the final case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.