Sneeze stifle blows hole in man’s throat
MEDICS are warning flu-hit folk not to stifle sneezes for fear of potentially acute consequences.
The alert comes from ear, nose and throat experts at University Hospitals Leicester as cold and flu bugs sweep the nation.
A study, published online in British Medical Journal (BMJ) case reports, says attempting to hold in a sneeze can cause significant harm and details a real life example.
Primary author Dr Wanding Yang writes that a previously fit and well 34-year-old man was hospitalised for a week, fed through a tube and given intravenous antibiotics after sneezing a tear in the top part of this throat.
He’d turned up at A&E when his throat swelled up and he found it difficult to speak a few hours after feeling a popping sensation in his neck when smothering a “forceful” sneeze.
The report entitled Snap, Crackle and Pop: When Sneezing Leads to Crackling in the Neck, explains how holding his nose and closing his mouth to prevent the sneeze had basically blown a hole in this throat - according to medical jargon suffering a “spontaneous perforation of the pharynx”.
Presenting at casualty doctors were initially perplexed. There was no evidence of disease or fever, no trace of injury and the man said he hadn’t swallowed anything sharp.
Fibre optic investigations revealed nothing although a physical examination detected popping and crackling sounds from his neck to his ribcage - a sign that air bubbles had found their way into the deep tissue and muscles of the chest.
It was only following an X-ray and urgent CT scan that this was confirmed.
Luckily the tear was small and no surgical intervention was required but because of the risk of complications he was admit- ted, fed by a tube and given intravenous antibiotics until the swelling and pain had subsided.
After a week the man was well enough to be discharged with the advice not to block both nostrils while keeping his mouth shut when sneezing in future.
Dr Yang said: “Halting sneezing via blocking (the) nostrils and mouth is a dangerous manoeuvre, and should be avoided.
“It may lead to numerous complications, such as pseudomediastinum (air trapped in the chest between both lungs), perforation of the tympanic membrane (perforated eardrum), and even rupture of a cerebral aneurysm (ballooning blood vessel in the brain)”
“Luckily, it was a very small perforation,” Yang said. “He didn’t need any operation.”
A sneeze is your body’s protective reflex to rid itself of an irritant in the nose. It prompts a significant amount of air pressure to build up in the lungs to force out the irritant through the nasal cavity.
This pressure can propel mucous droplets at a rate of 100 mph so if the sneeze is held back that pressurized air has to go somewhere. In this case, it injured the tissue in the man’s throat.
This kind of sneezing injury is unusual, according to the report. Doctors have seen patients with similar injuries after coughing heavily or after vomiting forcefully.
Other medical experts say the injury is more likely seen as the outcome of a trauma such as being involved in a car crash, being hurt by a gunshot or knife, or after having swallowed something sharp.
In the case study Dr Yang says due to the condition’s rarity, seeming non-specific presentation and general lack of awareness, diagnosis and intervention may be delayed, resulting in potential complications for the patient.