When you feel a sneeze coming on, it’s best to let it out. Otherwise, you may end up tearing a hole in your throat.
That’s the advice doctors are issuing after a man in his 30s experienced a spontaneous tracheal perforation – a potentially fatal condition – while trying to stifle a sneeze while driving.
The man struggles to suppress a sneeze by pinching his nose and closing his mouth at the same time, and the man suddenly feels a shooting neck pain. He was taken to the emergency unit in Dundee in distress.
Doctors at Ninewells Hospital were stunned to hear a cracking sound after touching his neck and found he had no control of movement. CT scans revealed that the man had torn his windpipe.
The case was reported in the medical journal BMJ Case Reports. Dr Rasads Misirovs, the lead author of the report, told the Guardian on Thursday that he and his colleagues were initially puzzled about the cause of the man’s condition.
“The patient who presented to the hospital with a sudden swollen neck after sneezing was quite surprising to us,” he said. “None of us have encountered such a representation before, except for holes in windpipes after injuries or complications from operations.”
The key to unlocking the mystery of what happened was confirming the exact sequence of events, Misirovs said, followed by extensive scans of the patient.
“X-ray of the soft tissues of the neck showed air in parts of the neck structures where there should be no air. We performed computed tomography of the neck and chest which showed the extent of trapped air in neck and chest tissues and the location of the hole in the trachea.”
Misirovs said the case is unique. “The chance of experiencing complications like this one is extremely rare, almost never. It’s like winning the million-pound lottery – a rare but potentially life-changing complication.”
In this case the man had a lucky escape. He was given pain medication, admitted to hospital and kept under close observation for 48 hours. Within five weeks the hole in his throat healed.
It could have been much worse, Misirovs said. If the mouth and nose are both closed during a sneeze, the pressure in your upper airways can increase by up to 20 times.
“The worst-case scenario could be a ruptured trachea leading to suffocation,” he said, or even a bleed in the brain.
So what should people take from this episode? “My advice is to let the sneeze out, as it is the body’s natural defense mechanism to expel irritants from the nasal passages,” Misirovs said.
“We need to cover the face lightly, either with our hand or the inside of the elbow to prevent the irritants such as viruses, along with saliva and mucus, from reaching others around us.”
