July 30, 2015

Is Suppressing a Sneeze Bad For You?

Image courtesy of stockimages
at FreeDigitalPhotos.net

Also known medically as the "closed-airway sneeze," it may be socially preferable, but healthwise may be harmful if not dangerous.

With a sneeze, tremendous air pressure is created in the lungs which ideally should be released out the mouth... but if internalized to prevent release out the mouth, can cause immense pressure to buildup internally which may cause significant damage ranging from minor to severe requiring hospitalization. Based on a 2000 study, intranasal pressures up to 176 mmHg for closed-nose sneezing was measured whereas with open nose sneezing, a mean intranasal pressure of 4.6 mmHg was reached.

Although most of the time, no adverse health consequences occur, here are some of the reported damage that has happened by stifling a sneeze:

Breaking the cartilage around the voicebox
Cervical pain
Facial fracture
Rupturing the eardrum
Stapedial Fracture causing hearing loss
Subcutaneous Emphysema
Rib fractures
Hernia
Eye damage
Vision damage
Spinal injury
Arterial rupture
Hematoma formation in the neck and other locations
• Vocal cord damage

So do as Elsa of Frozen fame would say/do... "Let it go!!!"



References:
The "closed-airway sneeze": an unusual cause of laryngeal fracture. Otolaryngol Head Neck Surg. 2011 Sep;145(3):515-6. doi: 10.1177/0194599811402947.

Acute cervical pain syndrome resulting from suppressed sneezing. J Assoc Physicians India. 2008 Sep;56:728-9.

Laryngeal injury and subcutaneous emphysema caused by an episode of sneezing: A rare case treated with observation alone. J Laryngol Voice [serial online] 2016 [cited 2019 Mar 11];6:21-4.

Sneezing and orbital fracture. Plast Reconstr Surg. 2006 Mar;117(3):1049-50.

Sudden conductive hearing loss following sneezing. Arch Otolaryngol. 1973 May;97(5):413-4.

Fractured Rib, Diaphragmatic Rupture and Chest Wall Hernia after Heavy Sneezing. Zentralbl Chir. 2015 Jun;140(3):337-8. doi: 10.1055/s-0034-1383100. Epub 2014 Nov 17.

Orbital emphysema after a protracted episode of sneezing in a patient with no history of trauma or sinus surgery. Ear Nose Throat J. 2010 Nov;89(11):E12-3.

Spontaneous Retrobulbar Haematoma. Case Rep Radiol. 2015;2015:796834. doi: 10.1155/2015/796834. Epub 2015 May 10.

Spontaneous spinal epidural hematoma after abrupt sneezing with prompt recovery of severe paraparesis. Am J Emerg Med. 2014 Dec;32(12):1555.e3-5. doi: 10.1016/j.ajem.2014.04.039. Epub 2014 Apr 26.

Internal carotid artery aneurysm with life-threatening hemorrhages in a pediatric patient: endovascular treatment options. J Endovasc Ther. 2004 Dec;11(6):734-8.

Cervico-mediastinal haematoma following sneezing. Anaesthesia. 1975 Jan;30(1):50-3.

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. He is also the chief medical officer of O2Labz, a medical and scientific 3D animation company.

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