In what has been described as a first-of-its-kind medical case, a man in his 30s ended up with a hole in his throat after pinching his nose and pressing his lips shut in order to surpress a sneeze.

The unnamed man was taken to Ninewells Hospital, in Dundee, Scotland, in severe pain, after trying to stifle a sneeze by pinching his nose and closing his mouth shut while driving. Apparently, when you do something like that, the pressure in the upper airways can increase by about 20 times, which can lead to serious injuries including ruptured eardrums, aneurysms, and even broken ribs. However, in this particular case, the unnamed patient ended up with a 2mm tear in their windpipe, which caused excruciating pain. A throat tear, known medically as a “spontaneous tracheal perforation” is a rare and potentially life-threatening injury that had not been associated with sneeze stifling before.

When the man arrived at the emergency room, he was in severe pain, his neck was swollen on both sides and he could barely move his head. He told doctors that he was going through a bout of hay fever while driving, and when he got the urge to sneeze, he just held it in by pinching his nose and closing his mouth. He ended up with a torn windpipe.

While examining the patient, doctors could hear a faint crackling sound from inside her throat, indicating that something was not right. Luckily, the condition did not interfere with breathing, swallowing or talking. Following the diagnostic, the patient was discharged and given painkillers and hayfever medication, with the recommendation to abstain from strenuous activity for two weeks. Five weeks later, he returned for a checkup and checkup found that the tear had healed up.

“We should gently cover the face either with our hand or inner side of the elbow to prevent the irritants such as viruses, together with saliva, mucus reaching others around us,” Dr Rasads Misirovs told the BBC. “I personally have used another technique by pressing a thumb on my upper lip, just under the nose, without blocking nasal passages for a few seconds – that works for me. “By leaving nasal passages open, the sneeze can escape if the stifling does not work.”