Emphysema of the periorbital region and mediastinum in a young child following a dental procedure

A 5-year-old boy presented with periorbital swelling due to craniofacial emphysema after a dental procedure. Computed tomography also revealed emphysema of the mediastinum. Pneumoparotitis and anesthesia mumps were considered in the differential diagnosis; however, Stensen's duct as well as the parotid itself appeared normal. It was determined that the most probable cause was dissection of soft tissues around the tooth using air-driven dental handpieces or air syringes, causing air to spread from the buccal, sublingual, and submandibular spaces to the mediastinal compartment inferiorly and cervicofacial compartment superiorly.