Man ruptured his throat by holding his nose and closing his mouth when sneezing
Holding your nose and closing your mouth while you sneeze might seem a harmless thing to do, but doctors have advised against it following the case of man who ruptured the back of his throat when doing so.
Ear, nose and throat specialists at the University Hospitals of Leicester NHS Trust said trying to contain a forceful sneeze in such a way is not a good idea as it could lead to "numerous complications".
Writing in the journal BMJ Case Reports, they described the case of a 34-year-old man, described as previously fit and well, who spent a week in hospital and was left barely able to speak or swallow after suffering spontaneous perforation of the pharynx.
They said the "unusual condition" is most often caused by trauma or sometimes by vomiting, retching or heavy coughing, so the patient's symptoms initially surprised emergency care doctors.
He told them he had developed a popping sensation in his neck which immediately swelled up after he tried to contain a forceful sneeze by pinching his nose and keeping his mouth clamped shut at the same time.
He then found it extremely painful to swallow and could barely speak.
When doctors examined him they heard popping and crackling sounds, which extended from his neck all the way down to his ribcage, a sign that air bubbles had found their way into the deep tissue and muscles of the chest - later confirmed by a scan.
Because of the risk of serious complications he was admitted to hospital where he was fed by a tube and given intravenous antibiotics until the swelling and pain had subsided.
After seven days the man, who has not been identified, was well enough to be discharged with the advice not to block both nostrils when sneezing in future.
"Halting sneezing via blocking (the) nostrils and mouth is a dangerous manoeuvre, and should be avoided," the authors said.
"It may lead to numerous complications, such as pseudomediastinum (air trapped in the chest between both lungs), perforation of the tympanic membrane (perforated eardrum), and even rupture of a cerebral aneurysm (ballooning blood vessel in the brain)," they added.