Sinusitis

16 January 2018

Holding a sneeze blew a hole in this man's throat

A British man lost his voice and spent a week in hospital after he tried to stop a forceful sneeze by pinching his nose and closing his mouth.

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Did your mother warn you not to stifle a sneeze? Now there's actual evidence that it can lead to something serious – a ruptured throat.

English doctors recently reported that stifling a big sneeze can be hazardous for your health, based on the very unusual experience of a man who ruptured the back of his throat when he tried to stop a sneeze.

Injuries associated with trauma

In a case study published in the journal BMJ Case Reports, doctors described their initial confusion when the previously healthy man turned up in the emergency room of a Leicester hospital, complaining of swallowing difficulties and "a popping sensation" in his swollen neck.

The 34-year-old patient told them his problems started after he tried to stop a forceful sneeze by pinching his nose and closing his mouth. He eventually lost his voice and spent a week in the hospital.

Another physician described the episode as "exceedingly rare" and said the man's injuries are more commonly associated with trauma.

"When you sneeze, air comes out of you at about 150 miles per hour," said Dr Anthony Aymat, director for ear, nose and throat services at London's University Hospital Lewisham, who was not involved in the case. "If you retain all that pressure, it could do a lot of damage and you could end up like the Michelin Man with air trapped in your body."

'Exceedingly rare occurrence'

While examining the sneeze-averse patient, doctors in Leicester heard "crackling in the neck" down to his ribcage, a sign that air bubbles had seeped into his chest. Worried about infection and other possible complications, they admitted him to the hospital, gave him a feeding tube and administered antibiotics, according to details published in BMJ Case Reports.

Dr Zi Yang Jiang, a head and neck surgeon at University of Texas Health Science Center at Houston, said he sees one or two cases arising from repressed sneezes each year, making them an "exceedingly rare" occurrence.

Jiang said it was bizarre that a single sneeze could generate enough force to cause the kind of physical damage that usually results from trauma, such as a gunshot wound to the neck. A collapsed lung is among the problems that retaining the air from an imminent sneeze can cause, he said.

"The whole point of sneezing is to get something out of your body, like viruses and bacteria, so if you stop that, those may end up in the wrong part of the body," he said. Jiang said in most cases, the excess air is later absorbed by the body.

The English patient made a full recovery and was advised to avoid plugging his nose while sneezing in the future. Doctors recommend letting sneezes rip into a tissue instead.

"The safest thing to do – although it's not socially acceptable – is just to sneeze loud," Aymat said.

Image credit: iStock

 

Ask the Expert

Sinusitis Expert

Dr Gary Kroukamp MBCHB, FCORL(SA) is an ENT Specialist, practising from rooms at Kingsbury Hospital in Claremont, Cape Town. He also has a teaching sessional appointment as an ENT Consultant at the Tygerberg Hospital. He is a member of the ENT Society of South Africa and the South African Cochlear Implantation Group. His interests in the ENT field include sinusitis and sinus surgery, nasal allergy and ENT conditions in children.

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