Gesundheit! Stifling a sneeze can cause injuries in rare cases, experts say

TORONTO – With influenza cases continuing to rise in Canada, there is likely to be a great "aooing" throughout the country. But ear, nose and throat doctors advise against trying to stifle those sneezes, since such suppression can cause injuries in rare cases.

One of the most serious is detailed in the BMJ journal Case Reports, published online on Monday, in which a 34-year-old man from the United Kingdom broke his throat after pinching his nose and closing his mouth to contain a strong sneeze

The trauma after sneezing left the man in pain and could barely speak or swallow. 19659002] When emergency physicians examined the patient, they heard clicking and crackling sounds that extended from his neck to his rib cage, a sign that air bubbles had entered the tissue and muscles of his chest, the authors of University Hospitals of Leicester NHS Trust write.

The unidentified man, who was treated at the hospital for a week, was advised not to repeat a "dangerous maneuver" in the future.

"This tear in the throat is incredibly unusual," he said. Dr. Douglas Chepeha, specialist in otorhinolaryngology (ENT) of the University Health Network in Toronto. "In my career, I've never seen anything like it."

However, he said that there are several other injuries that could occur when trying to block a sneeze, although they are also relatively rare. [19659002] Preventing the release of air from the nose and mouth during a sneeze could rapidly increase the pressure in the lungs, forcing out the air and trapping it in the chest between the lungs, a condition known as pseudomediastinum.

A repressed sneeze could also increase the pressure in the middle ear, although Chepeha said bursting an eardrum that way is very rare. (To understand the effect, think of popping the ears on an airplane descending by breathing against the pinched nostrils to restore hearing)

In the BMJ case report, the authors point out that frustrating a sneeze: the intent of the body to eliminate such irritants as mucus or allergens in the nose – an undetected aneurysm, or a balloon blood vessel, in the brain could be ruptured.

And it could also cause the explosion of small blood vessels on the surface of the eyes and other areas of the head and neck at the accumulated pressure, said Chepeha.

"In your nose, you can burst a blood vessel and bleed your nose."

Even without being prevented, sneezing is known to cause injuries, said Dr. Eric Monteiro, an otolaryngologist at Mount Sinai Hospital in Toronto.

"There have been reports of older women developing brittle bones in osteoporosis and developing vertebral compression fractures as a result of sneezing," she said in an interview Monday. [19659002] Some Major League players have been hurt with sneezing, including Toronto Blue Jay player Kevin Pillar, who wound up on the 10-day disabled list when a sneeze caused oblique muscle distention during the 2015 preseason. [19659002] correct way to sneeze

Not really, said Monteiro, explaining that sneezing is an involuntary reflex of protection that can not necessarily be controlled.

"But I think there is a wrong way, that he is trying to cover his nose and close his mouth, which is generally not recommended because it inhibits the natural process," he said.

"And if he does, he may be prepared for an injury, despite the fact that they are rare."

While doctors may discourage people from suppressing a sneeze, be it a delicate achoo or a honking, Chepeha said that people should take it to the inside elbows to prevent the spread of influenza virus or other airborne insects.

"Of course you have to cover your mouth, and the absolute best way is to cough or sneeze into your sleeve"

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