skip to main content

Subcutaneous Emphysema Management — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateOral SurgerySubcutaneous Emphysema ManagementORE Part 1

During crown preparation using an air turbine, a patient develops sudden unilateral cheek swelling with palpable crepitus. The swelling is localised to the cheek. They are comfortable, with normal observations and no dysphagia, dyspnoea, voice change, neck swelling or chest pain. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Give antibiotic cover, observe closely, provide safety-net advice and reassure

Explanation lettering: C = shown as A · A = shown as B · B = shown as C

A is correct. Sudden swelling with crepitus during air-turbine use indicates subcutaneous emphysema. In this localised presentation, without airway, neck or chest symptoms, management is conservative: stop the procedure, provide antibiotic cover, observe, reassure and give safety-net advice to seek urgent assessment for dyspnoea, dysphagia, voice change, neck or chest swelling, or chest pain. Air is normally resorbed over several days. Needle aspiration, incision and tight compression do not prevent air tracking through fascial planes and may add trauma or infection risk. Discharge with no management is unsafe because observation and advice are needed to identify uncommon progression or secondary infection.

Reference: Schuman NJ, Owens BM, Shelton JT. Subcutaneous emphysema after restorative dental treatment. Compendium of Continuing Education in Dentistry, 2001. https://pubmed.ncbi.nlm.nih.gov/11911057/