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A Man Ruptured His Throat From Trying to Hold in a Sneeze

Under no circumstances should you pinch your nose and close your mouth to contain a sneeze.

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Jan 15 2018, 11:30pm

Lateral soft tissue neck radiograph with narrow window setting shows streaks of air in the retropharyngeal region (black arrow) and extensive surgical emphysema in the neck anterior to the trachea (white arrow). Image: BMJ Case Reports

Sneezing etiquette isn’t that complicated. When your body expels a fine mist of potentially virulent droplets, you want to keep that stuff away from other people. Use a tissue or, in a pinch, your sleeve or elbow. Throw the tissue away. Wash your hands. Wash your elbow.

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Under no circumstances, though, should you pinch your nose and close your mouth to contain or try to stifle a sneeze. While doing so may spare the people around you from your filth, in rare cases it can rupture the back of your throat, as one man unfortunately found out.

This cautionary tale comes a paper from BMJ Case Reports: An otherwise healthy 34-year-old man went to the emergency room with painful swallowing and an altered voice. He told doctors that, after pinching his nose and holding his mouth closed to try to stop a sneeze, he felt a popping sensation in his neck, followed by some swelling. Soon after, swallowing became extremely painful and he virtually lost his voice.

The doctors examining him heard popping and cracking sounds from his neck down to his ribcage; they determined that air bubbles had formed in the deep tissues and muscles of his chest. As you may have guessed, that’s not a good thing. Then doctors found the tear in the back his throat using a CT scan.

The man was admitted to the hospital, where he had a feeding tube inserted so food couldn’t get stuck in or pass through the hole in his throat, and received IV antibiotics to stave off infection. The swelling and pain subsided, and after seven days he was discharged with instructions not to block his nostrils next time he sneezes.

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Doctors were initially surprised at the diagnosis, as spontaneous throat-rupturing is rare. It’s usually caused by trauma, though vomiting, retching, and heavy coughing can also cause a tear. And, apparently, so can stifling a sneeze. The authors are sharing the case to help other professionals identify potential cases quickly, as it can lead to serious complications without treatment. (And we’re sharing with you, dear reader, so you don’t do it.)

Even though it’s rare, the authors still warn that "halting sneezing via blocking [the] nostrils and mouth is a dangerous manoeuvre, and should be avoided.” Besides the rare throat perforation, it can have other serious consequences, from air trapped in the chest between the lungs, to perforated eardrums, to brain aneurysm.

In summary, do not pinch your nose to kill a sneeze. Just don’t do it.

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