An Oakland University William Beaumont School of Medicine student has published a first-of-it-kind study drawing attention to head and neck injuries that can occur as a result of e-cigarette malfunctions.

Unique study led by OUWB student draws attention to vaping-related injuries
Exploding E-Cig

An Oakland University William Beaumont School of Medicine student has published a first-of-its-kind study drawing attention to head and neck injuries that can occur as a result of e-cigarette malfunctions.

Fourth-year medical student Antonio Dekhou was lead author on “E-Cigarette Burns and Explosions: What are the Patterns of Oromaxillofacial Injury?

The study recently was published in the Journal of Oral and Maxillofacial Surgery.

Dekhou said the study is a first in that it provides a systematic review of cases in which e-cigarettes malfunctioned and caused head and/or neck injury to patients.

“We want people to avoid underestimating the potential damage that occur with e-cigarette use,” said Dekhou.

“It’s not just the smoke and the long-term side effects…there is risk of acute injury.”

The risks of e-cigarettes

E-cigarettes are known by many different names, including e-cigs, e-hookahs, mods, vape pens, vapes, tank systems, and electronic nicotine delivery systems (ENDS).

E-cigarettes come in many shapes and sizes. Some look like traditional cigarettes, cigars, or pipes. Some look like pens or USB drives.

Antonio Dekhou


Use of such devices is commonly referred to as “vaping.” Dekhou said it’s important to note that there are no regulations with regard to vaping devices.

According to the CDC, e-cigarettes produce an aerosol by using batteries to heat a liquid that usually contains THC and/or nicotine (the addictive drug in other tobacco products). The aerosol also has other chemicals and flavoring.

The CDC says in addition to the dangers of inhaling the toxic aerosol, defective e-cigarette batteries have caused fires and explosions, “some of which have resulted in serious injuries.”

Dekhou, who plans to specialize in otolaryngology, said the study he led looked specifically at such explosions when they caused acute injury to the neck and head. Data was pulled from PubMed and Embase.

“This study demonstrates that e-cigarette device malfunctions and explosions carry risk for severe oromaxillofacial trauma,” the study states. “With the increasing popularity of electronic cigarette use, clinicians and patients should be well-versed in the dangers associated with e-cigarettes.”

A need to discuss e-cig risks

Twenty-one cases met the criteria to be part of the study. Of those, 100 percent were male with a mean age of 29.5 years. The most common lacerations and/or burns involved the lips, tongue, soft and/or hard palate, and nose. Thirteen subjects underwent surgeries include oral-maxillofacial surgery or dental implants, bone graft repair, open reduction and internal fixation for preservation of sinus outflow tracts, and iridectomy.

Dekhou said in one extreme case, an e-cigarette malfunctioned and launched into a patient’s mouth and ended up fracturing the person’s cervical spine.


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He also noted that users face danger beyond the initial “explosion” because of the chemicals that can end up in a patient’s mouth, esophagus, stomach, etc. Dekhou said research for the study found a case in which the patient now has feeding tube because he can no longer swallow as a result of an e-cigarette explosion.

Dekhou said he hopes more e-cigarette users become aware of such possible dangers before they start using the devices — especially as use increases. According to the 2020 National Youth Tobacco Survey, data show that 38.9 percent of current high school e-cigarettes users use the devices 20 days or more per month, up from 34.2 percent in 2019.

He also hopes that more clinicians become aware of the potential dangers to properly educate patients.

“When giving patients advice on why to stop smoking…I think that this risk with electronic cigarettes should be discussed, too,” he said. “Because if long-term cough, lung cancer, and whatnot doesn’t make someone want to stop smoking, perhaps the potential to have their face kind of blown off by an electronic device might.”

Co-authors on the study were Nicole Oska, B.S., student at University of Michigan; Benjamin Partiali, M.D., OUWB Class of 2021; Jared Johnson, M.D. and Michael T. Chung, M.D., both Wayne State University School of Medicine residents; and Adam Folbe, M.D., Otolaryngology-Head & Neck Surgery at Beaumont Health, Royal Oak.

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