Horrific scans reveal why you should never hold in a sneeze – as hay fever sufferer, 30, perforates his windpipe

A MAN tore a hole in his throat after holding in a sneeze, doctors have revealed in the first known case of its kind.

The unnamed Scottish patient, in his 30s, tried to stifle a bout of sneezing by pinching his nose and closing his mouth while driving.

The pressure from the sneeze was so great it tore a 0.08 inch hole in his windpipe and he had to rush to hospital.

He was in agonising pain and doctors could hear a crackling noise when he breathed, although he was still able to talk, swallow and breathe.

Dr Rasads Nisirovs, of the University of Dundee, said the case should serve as a warning to people not to try and hold in a sneeze.

He said: “Everyone should be advised not to stifle sneezes by pinching the nose while keeping the mouth closed as it can result in tracheal perforation.”

The man suffered from allergic rhinitis, a common condition where the nose becomes irritated by something you’re allergic to, like pollen.

It can cause sneezing, an itchy, runny or blocked nose, itchy, red and watery eyes, a cough and an itchy roof of the mouth.

Many people refer to it as hay fever, which affects around a quarter of British adults, according to Allergy UK.

Sneezing causes pressure in the airways to increase, but holding them in can cause this build-up to be around 20 times higher.

The man’s case, reported in BMJ Case Reports, is the only known time when this caused a rip in the throat.

When he arrived at the hospital’s emergency department, his neck was swollen on both sides and he was struggling to move it.

An X-ray revealed he had surgical emphysema — when air gets trapped in the deepest tissues under the skin.

CT scans showed the tear was between the third and fourth bones of his neck and air was building up in the space between the lungs in his chest.

Doctors decided he didn’t need surgery but monitored him for two days in hospital to check his oxygen levels stayed steady.

They then discharged him and gave him painkillers and hay fever drugs, and the tear healed in five weeks.

Dr Nisirovs said: “Conservative management of tracheal tears is an option in clinically stable patients not requiring mechanical ventilation with small tracheal tears. 

“The patients must be closely monitored as inpatients for 24 to 48 hours for any deterioration.”

How to treat hay fever

Holly Shaw, a nurse advisor for Allergy UK, told the Sun: “Treatment choice is very personal and often led by severity of the symptoms – often a combination of treatments will often help improve hay fever symptoms.”

She suggested you use a daily non-sedating antihistamine, nasal sprays and barrier balms.

“Other measures that can be used to manage hay fever include reducing exposure to pollen.”

She advised you:

• Wear a mask, wraparound sunglasses and a hat with a peak or large brim to keep pollen allergens out of your eyes and face. 
• On high pollen days, shower or bath, wash your hair and change your clothes when you arrive home. This will help to prevent continued exposure to the pollens indoors. 
• Keep windows closed. This is most important in the early mornings when pollen is being released and, in the evening, when the air cools. 
• Avoid mowing lawns or raking leaves yourself. 
• Avoid drying clothes/linen outside when pollen counts are high. 
• Wipe pets down with a damp cloth to remove pollens. 

Pollen counts are rising across the UK – and things are about to get a whole lot worse, the Met Office warns.

By June 20, they will be “very high” across the whole of England, Wales and Northern Ireland, and much of Scotland.

Strathclyde and Central, Tayside and Fife will get off slightly, but pollen counts are still due to be “high”.

Only Grampian, the Highlands and Eilean Siar, and Orkney and Shetland will see “moderate” levels.