The next time you feel your nose start to tickle, don't hold back. That's the advice from doctors after a British man ripped a hole in his throat trying to stifle a powerful sneeze.

Key points: Man plugged both nostrils and clamped mouth shut, but the force of the sneeze ruptured his throat

Man plugged both nostrils and clamped mouth shut, but the force of the sneeze ruptured his throat Doctors say the injury is very rare, but warn against blocking both nostrils to stifle a sneeze

Doctors say the injury is very rare, but warn against blocking both nostrils to stifle a sneeze Suppressing sneezes can also injure eyes, chest, ears, Australian specialist says

The 34-year-old man attempted to suppress a sneeze by clamping his mouth shut and blocking both nostrils, but the resulting force perforated his pharynx, the part of the throat just above the larynx and oesophagus, according to a case report in The BMJ published on Tuesday.

He soon found it impossible to swallow without extreme pain and all but lost his voice.

Spontaneous rupture of the pharynx is very rare, usually caused by vomiting, retching, heavy coughing or some kind of trauma, so emergency care doctors were initially surprised by the man's symptoms.

Once they figured out what had happened, they had to take action quickly, as the rupture allowed air bubbles to find their way into the tissue and muscles of his chest, causing popping and crackling sounds that extended from his neck all the way down his rib cage.

Apart from the pain, the injury left the man at risk of complications such as deep neck infection. He was put on a feeding tube and given intravenous antibiotics to protect against infection until the swelling and pain subsided.

Finally, a week after being admitted to hospital, he was sent home with the advice to not block his nose when sneezing in the future.

"Halting sneeze via blocking nostrils and mouth is a dangerous manoeuvre and should be avoided," the authors wrote.

Sneezing risks not confined to the throat

The British man's case is unusual, but not unheard of, according to rhinology specialist Professor Richard Harvey from the University of New South Wales and Macquarie University.

There was a similar case published in 2011, Professor Harvey said, and many other cases where stifling a sneeze has led to air pockets ending up where they shouldn't be.

"There's other things you can bust by holding in a sneeze," he said.

"You can blow air into your orbit — basically your eye socket."

This condition is called orbital emphysema.

"Most people who get orbital emphysema it just looks awful, they get this big puffy eye. It's not usually associated with sight loss."

Emphysema — air pockets in soft tissue — can also occur in your chest and neck if you hold in a sneeze or even just blow your nose too hard, Professor Harvey said.

He said a sneeze or nose blow could even force air up into someone's forehead cavity or brain if their anatomy makes them more susceptible to these types of injuries, or if they've recently had surgery in the nasal area.

Sneezing freely is less likely to injure you than trying to suppress it, experts say.

There is also a case of someone who sustained permanent hearing loss from sneezing, Professor Harvey added.

"They transmitted the force of the sneeze up their nose, through the eustachian tube and up into their middle ear," he said.

The force of that sneeze broke one of the little, mobile bones in the ear involved in hearing.

Bottom line? When it's time to sneeze, let it rip — so to speak.

"The whole point in sneezing is that you don't hold a sneeze in," Professor Harvey said.

"Don't hold your sneeze in. And don't force your nose blow."

Just make sure you direct those unstifled sneezes into your elbow to avoid spreading germs.