1666 An Isolated Maxillary Sinus Fracture Associated with Extensive Subcutaneous Emphysema and Pneumomediastinum

Subcutaneous emphysema is a common entity following facial trauma. However, pneumomediastinum secondary to isolated facial fractures is a rare and potentially life-threatening complication. We present a case of a 26-year-old female that presented with sudden onset left sided facial swelling over the left periorbital and zygomaticomaxillary region and some bruising overlying the left maxilla. In addition to palpable crepitus that was present over the left temporal and left supraclavicular regions following blunt trauma. There was no associated difficulty breathing or dysphagia and it was unclear whether she had blown her nose earlier that day. Computed tomography confirmed the diagnosis and extension of the pneumomediastinum. In conclusion, pneumomediastinum is a rare complication of blunt facial trauma. Prophylactic antibiotics should be considered to reduce the risk of mediastinitis and nose blowing should be avoided. Due to a lack of clear guidelines when managing this condition, sound clinical judgement with a high index of suspicion is recommended.