Did your mother ever warn you that holding in a sneeze can be dangerous? You might have chalked it up to one of those health myths that gets passed down from generation to generation because nobody bothers to actually look into it, but as it turns out, there is some truth to the idea. On Monday, a paper published in the medical journal BMJ Case Reports reported that an anonymous British man blew a hole in his neck by holding in a particularly strong sneeze. It looks like your mom's advice is nothing to sneeze at.
According to the case report — cleverly titled "Snap, crackle and pop: when sneezing leads to crackling in the neck" — a "previously fit and well" 34-year-old man showed up to an emergency room in the UK with a swollen neck. Several hours before, he had tried to hold in a sneeze by pinching his nose shut and keeping his mouth closed. Later, he told doctors that he had felt a "popping sensation in his neck" at the time, but he didn't think anything of it until his voice started to change pitch and his throat swelled.
After that, he was naturally a bit alarmed, so he checked himself into the hospital. In addition to the swelling, doctors noticed that a crackling noise when they examined his soft tissue, indicating air bubbles in his muscles. A CT scan supported this, showing "streaks of air in the retropharyngeal region and extensive surgical emphysema in the neck anterior to the trachea." This was thought to be caused by a perforation in his pharynx.
Allow me to put that in non-medical terms: By smothering his sneeze, the man managed to tear a hole in his throat.
Luckily, Dr. Wanding Yang told CNN that it was a relatively small hole. Following a two-week hospital stay, he was cleared to go home.
In the case report, doctors pointed out that this type of injury is normally caused by blunt trauma, but it can happen spontaneously when there is a "sudden rise in intraluminal pressure against closed vocal folds often following coughing, straining, forceful retching or vomiting." Now, sneezing can be added to the list — especially when the sneeze is smothered.
"Halting sneeze via blocking nostrils and mouth is a dangerous manoeuvre [sic] and should be avoided, as it may lead to numerous complications," warned doctors in the case report.
While blowing a hole in your throat is admittedly unlikely, it's not a good idea to hold in a sneeze. Our bodies use sneezes to expel airborne irritants out of our lungs at speeds of up to 100 miles an hour. "Prior to a sneeze, a significant amount of air pressure builds in the lungs in preparation of being forced through the nasal cavity to clear irritants out of the nasal passages," explained University of Arkansas for Medical Sciences (UAMS) doctor Allison Catlett Woodall.
When all that pressure is held back, it can break blood vessels in your eyes, force air up your Eustachian tubes into the inner ear, or even weaken blood vessels in the brain.
The good news is that there's a difference between holding back a sneeze and stifling one that's already happening. Although you might pull some funny faces, resisting the urge to sneeze won't land you in the hospital. Blocking your mouth and nose while a sneeze is in progress, though, can end in injury.
In the end, it's up to you to decide what's worse: Rupturing your ear drums, or sneezing in public? When put that way, it's probably not a difficult decision. Just do everyone else a solid and cover your nose before spewing your germs at high speeds.