【Dear Utol (2025): Doctor, Doctor I'm Sick Episode 41】

By now,Dear Utol (2025): Doctor, Doctor I'm Sick Episode 41 you've heard the story of the man who blew a hole in his throat while holding back a sneeze. Or, if you haven't heard the story, you've seen at least one alarmist headline while scrolling through Twitter.

Don't misunderstand me – I love this story! The patient is 100 percent FINE! And who knew a stifled sneeze could potentially ruin your whole week? But should we be dialing 911 in the half-second before we feel one coming on? Definitely not.

But first, a brief recap: A BMJ case report published Monday details an unusual medical case in which a British man suffered a "rare spontaneous perforation of the pyriform sinus" after pinching his nose and closing his mouth to suppress a sneeze.

To prevent further injury, the patient was admitted to a hospital and placed on a feeding tube for seven days while his throat healed.

"The patient was subsequently discharged with advice to avoid obstructing both nostrils while sneezing," the report authors write. Two months later, a check-up found the unlucky sneezer in fine health with no lasting complications.

Still, the authors conclude, "Halting sneeze via blocking nostrils and mouth is a dangerous manoeuvre and should be avoided, as it may lead to numerous complications such as pneumomediastinum, perforation of tympanic membrane and even rupture of cerebral aneurysm."

Sure, this all sounds pretty frightening, but how panicked should we be?

We reached out to Dr. William M. Portnoy, an otolaryngologist who confirmed that the force of a powerful sneeze can at times lead to complications for the same reasons the authors state in the case report.

"The pyriform sinus is a sort of pocket that goes alongside your voice box, and there’s no muscle there to reinforce it, so it’s basically just a loose mucus membrane," Portnoy says.

"It’s like blowing up a balloon: if you put too much force into it, yes it can conceivably burst and, as a manifestation of that, allow your saliva and air to get into a part of your body where it doesn’t belong and cause serious complications."

But even so, Portnoy says a case like this one is exceedingly rare.

Still, if you wanna play it super safe, there's a simple solution: Just let the sneeze happen.

"When you’re sneezing it’s because really there’s an irritation somewhere in your nasal cavity and your body is trying to forcefully discharge whatever that irritant might be in your respirator tree," he says.

But for moments when an audible sneeze might meant serious embarrassment, don't panic.

"I wouldn’t worry about sneezing with your mouth or your nose closed," Portnoy says. "But really the take home message is you should not close your nose and your mouth together when you sneeze because you’re inviting trouble."

Phew. Now we can all breathe – and sneeze – easy.