A criminal may try to induce subcutaneous facial emphysema in order to avoid identification by a witness.
Process:
(1) The patient makes 2 or more punctures in the mucosa at the rear of the upper limit.
(2) The patient performs several Valsalva maneuvers.
(3) The goal is to alter facial features by inducing subcutaneous emphysema.
Sites of air accumulation:
(1) zygomatic arch
(2) orbital region
(3) eyelids
This can easily go undetected. Having a photograph of the criminal can help in recognizing the changes.
If detected it may help to identify a suspect who is worried about being recognized.
Differential diagnosis:
(1) subcutaneous emphysema from other causes
(2) traumatic injuries
(3) allergy
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Specialty: Clinical Laboratory
