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HOLDING YOUR NOSE while closing your mouth to contain a forceful sneeze isn’t a good idea, doctors have warned.

One man managed to rupture the back of his throat during this manoeuvre, leaving him barely able to speak or swallow, and in considerable pain.

A case study published in the British Medical Journal notes: “A previously fit and well 34-year-old man presented to the emergency department with an acute onset of odynophagia (painful swallowing) and change of voice after a forceful sneeze.

“He described a popping sensation in his neck and some bilateral neck swelling after he tried to halt a sneeze by pinching the nose and holding his mouth closed.”

An x-ray showing streaks of air in the man's neck (black arrow) BMJ BMJ

Spontaneous rupture of the back of the throat is rare, and usually caused by trauma or sometimes by vomiting, retching or heavy coughing, so the man’s symptoms initially surprised doctors.

The man explained that 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.

A short time later he found it extremely painful to swallow and almost lost his voice.

Popping and crackling sounds

When doctors examined him they heard popping and crackling sounds (crepitus), which extended from his neck down to his ribcage.

This indicated that air bubbles had found their way into the deep tissue and muscles of the chest, which was subsequently confirmed by a computed tomography (CT) scan.

The man was admitted to hospital due to the risk of developing serious complications or an infection.

He was fed via a tube and given intravenous antibiotics until the swelling and pain had subsided. After seven days he was 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.

“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],” the authors of the case study explain.

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