Doctors caution holding in sneezes after man blows a hole in his windpipe: case study

A man tore a hole in his windpipe by pinching his nose and keeping his mouth shut during a sneezing episode, a case study says.

Doctors in Dundee, Scotland are using this “rare” situation as an example of what could happen if people hold in their sneezes under certain circumstances.

The case study, published in BMJ Journal, is possibly the first reported incident of a sneeze tearing a windpipe.

“That’s how we managed to get it published, because it’s very rare and hasn’t been reported before,” Rasads Misirovs, the lead researcher of the study, told CTVNews.ca in an interview.

“There is a small chance that there might be some other patients in the past that ended up creating a hole in their windpipe while trying to stifle a sneeze.”

In this case, a man in his 30s with allergic rhinitis, a disease that causes nasal congestion, experienced “severe neck pain” after stifling multiple sneezes in a row by pinching his nose and closing his mouth.

This happened while he was driving with a seatbelt across his chest. The seatbelt, Misirovs believes, played a factor in the situation.

“When we sneeze, there is increased buildup of pressure in the lungs and in the chest trying to expel the irritants from the nasal passage,” he said. “The tension with the seatbelt, nose pinched and mouth closed, the air did not have a place to escape, therefore, the combination of the three potentially … increased the chance of the windpipe to burst.”

After this happened, the man went to the emergency department where doctors, including Misirovs, saw that his neck was swollen and could not move.

An X-ray showed a small tear in his windpipe. This was concerning for doctors because air was going in areas that it shouldn’t.

“The heart might start to beat irregularly or the windpipe could collapse, therefore making it difficult to breathe,” Misirovs said. “There’s a risk of infection later on.”

The man was admitted to the hospital for two days while doctors gave him antibiotics to reduce the nasal congestion decreasing the likelihood he would need to sneeze, the study notes. There was no further treatment and the man’s windpipe healed.

The goal for the case study is to have a public record of the case. Misirovs said it’s possible that similar incidents have been reported before in other languages.

This incident should act as a cautionary tale to other doctors and members of the public, Misirovs said.

“People should be calm, they’re safe to sneeze,” he said. “There is a risk … the risk is very small that you will end up with a hole in your windpipe when you’re keeping your mouth and nose closed while you’re sneezing.”

Misirovs emphasized that despite the seatbelt possibly playing a role in the incident, people should continue to wear one while in vehicles.

He recommended people to sneeze into a tissue or into their elbow to keep germs from spreading.

“Sneezing is a natural way to protect us from the allergens that irritate our nasal passages,” Misirovs said. “Therefore, we should allow it to escape.”