The world has recorded the first known case of a man tearing a small hole in his trachea after trying to suppress a sneeze. If you have ever attempted to hold in a sneeze, this new medical case report might give you pause.
The strange incident occurred while the man was driving and felt discomfort in his throat. He suddenly had an overwhelming urge to sneeze, but instead of letting the sneeze out, he stifled it by pinching his nose and keeping his mouth shut.
When both the mouth and nose are closed during a sneeze, the pressure generated in the upper respiratory tract can exceed 20 times the normal level that builds up during a sneeze. In this man’s case, the pressure was so great that he tore a 2 x 2 mm hole in his trachea.
X-ray of the man’s neck showing air pockets trapped under the skin of his neck, as indicated by the arrows above. (Image: BMJ Case Reports 2023).
Upon arriving at the emergency department, the man was in severe pain, with swelling on both sides of his neck and difficulty moving. Upon examination, the doctors could also hear a faint crackling sound. However, the man did not have any issues with breathing, swallowing, or speaking.
The neck X-ray revealed that he had surgical emphysema, a condition where air becomes trapped beneath the deepest layers of tissue under the skin. A subsequent CT scan showed the tear located between the third and fourth vertebrae in his neck. Air had also accumulated in the space between his lungs.
The doctors concluded that the tear was caused by “rapid pressure buildup in the trachea when sneezing with the nose pinched and mouth closed.”
The medical team determined that the man did not require surgery. However, he was monitored in the hospital for two days to ensure his oxygen levels and other vital signs remained stable. He was later discharged with pain relievers and fever reducers. The doctors also advised him to refrain from any strenuous physical activity for two weeks. Five weeks later, a follow-up CT scan showed that the tear had completely healed.
This case has been documented in a report published on December 1 in the BMJ Case Reports, serving as a warning to others.
The authors of the report wrote: “People should not suppress a sneeze by pinching their nose while keeping their mouth closed as it can lead to tracheal rupture.”
Spontaneous tracheal rupture is very rare but can be fatal. Only a handful of cases have been reported, often due to blunt trauma or injury following medical procedures, such as thyroidectomy or tracheostomy.
The authors of the case report noted that, depending on the location of the tear and whether the patient’s vital signs are stable, surgery is often necessary to repair such injuries.
