A newly published study describes what can happen if you block your nostrils and close your mouth during a sneeze — and it isn’t pretty. The following advice should be heeded.

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Do you know how to sneeze safely?

Although no one likes a cold, you have to admit that a powerful sneeze can feel pretty good. In fact, I’ve heard that a sneeze is equivalent to one third of an orgasm.

I’m fairly sure that that statistic isn’t backed up by peer-reviewed research, but you get my point.

But, as a wise man once said, “All that glitters is not gold.” Sneezing may give you a pleasurable shiver, but, as we shall learn, it can also cause significant damage to your innards if you do it wrong.

Spontaneous rupture of the back of the throat is a rare occurrence. When it does happen, it is most often caused by a surgical procedure gone wrong or blunt neck trauma.

So, when a young, healthy 34-year-old who hadn’t been in an accident rocked up at an emergency room with a ruptured throat, the doctors were a tad perplexed.

The man explained that he had attempted to quash a sneeze by blocking his nostrils and mouth. He experienced an immediate popping sensation in his neck, which quickly swelled up. As time passed, it became painful to swallow, and his voice vanished almost entirely.

When the doctors examined him, they detected cracking and popping sounds, or crepitus, from his neck down to his ribcage. Crepitus is a sign that air bubbles have gained entrance to the deep tissues and muscles of the chest.

A scan confirmed that, as expected, the man had air bubbles in places where there shouldn’t be any air.

It turns out that one of the man’s sinuses, perhaps the piriform sinus, had perforated thanks to the sudden increase in pharyngeal pressure.

Just to give you the low-down on related medical terminology, when a gas enters tissues beneath the skin, it is referred to as subcutaneous emphysema. Meanwhile, pneumomediastinum occurs when air is found in the mediastinum, which is the central compartment of the thoracic cavity.

This unfortunate man experienced both of the above.

As the risk of complication was high, he was taken to hospital, fed by tube, and given intravenous antibiotics until his swelling and discomfort went away. In total, he spent 7 days in hospital before he was well enough to leave.

This intriguing, distressing story is reported in the latest edition of BMJ Case Reports. The article is titled “Snap, crackle, and pop: When sneezing leads to crackling in the neck.”

Before you become consumed with panic, it’s worth noting that this tale of woe was published in an illustrious journal because it is particularly uncommon. Having said that, is it really worth the risk? The advice from the authors is clear:

Halting sneezing via blocking [the] nostrils and mouth is a dangerous maneuvre, and should be avoided.”

The study authors also warn that plugging your facial holes as you sneeze might perforate your tympanic membrane, or eardrum, or even cause the rupture of a cerebral aneurysm, which is a “ballooning blood vessel in the brain.”

So, what should you do? You don’t want to fire germs willy-nilly from all your facial orifices each time you sneeze, especially not during flu season — you’re more considerate than that, I know.

The best advice — if you don’t have a handkerchief or tissue to hand — is to sneeze into the crook of your elbow; this will prevent wide distribution of your unwanted microbial flora. It also keeps the germs off your hands, making you less likely to spread them when you open doors, shake hands, play patty cake, or give a colleague a high five.

Bless you.