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April 20, 1963

Subcutaneous Facial Emphysema

Author Affiliations

Daytona Beach, Fla.

JAMA. 1963;184(3):250. doi:10.1001/jama.1963.03700160126027

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To the Editor:  —We should like to report an unusual case of subcutaneous emphysema of the face and neck in a 75-yr-old man after trauma to the left zygomatic complex and without radiologically proved fracture.The patient fell in the bathtub, hitting the lateral aspect of his left orbital rim. Shortly after the accident he asked for medical aid because of swelling of his left cheek.One of us (C. J. W.) first saw the patient about 3 hr after the accident. He complained of some "stiffness" of the neck and showed a well-defined hematoma of the left side of his face. There was also minimal abrasion in the left temporal area. Streptokinase-streptodornase (Varidase), 5,000 units four times a day, was prescribed.The next morning the patient was seen in the office. He complained of stiffness of the neck and difficulty in swallowing and even breathing. He noticed that when

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