Facial subcutaneous emphysema in a patient with connective tissue disorder

Abstract

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.