Subcutaneous orbital and facial emphysema is a rare condition that may
occur after a direct or indirect sinus trauma. A case report of a 25-year-old
female complaining of bilateral swelling of the eyelid, orbital area, and facial
puffiness, secondary to a violent nose-blowing. Computed tomography (CT)
confirmed the diagnosis of subcutaneous emphysema. The initial treatment plan
was puncture-suction and prophylactic intravenous antibiotic therapy. The
patient was advised to not blow her nose. There has been no improvement in the
patient’s condition on the tenth day, so we performed a bilateral nasal packing by two Merocels
(R), maintained for five days. After two weeks, the condition had completely
resolved.
References
[1]
Khader, Q.A. and Abdul-Baqi, K.J. (2010) Orbital Emphysema after a Protracted Episode of Sneezing in a Patient with No History of Trauma or Sinus Surgery. Ear, Nose & Throat Journal, 89, 12-13. https://doi.org/10.1177/014556131008901104
[2]
Zimmer-Galler, I. and Bartley, G. (1994) Orbital Emphysema: Case Reports and Review of the Literature. Mayo Clinic Proceedings, 69, 115-121. https://doi.org/10.1016/S0025-6196(12)61036-2
[3]
Li, T., Mafee, M.F. and Edward, D.P. (1999) Bilateral Orbital Emphysema from Compressed Air Injury. American Journal of Ophthalmology, 128, 103-104. https://doi.org/10.1016/S0002-9394(99)00037-9
[4]
Roelofs, K.A., Starks, V. and Yoon, M.K. (2019) Orbital Emphysema: A Case Report and Comprehensive Review of the Literature. Ophthalmic Plastic & Reconstructive Surgery, 35, 1-6. https://doi.org/10.1097/IOP.0000000000001216
[5]
Hatton, M.P. and Rubin, P.A. (2007) Management of Orbital Compartment Syndrome. Archives of Ophthalmology, 125, 433-434. https://doi.org/10.1001/archopht.125.3.433-b
[6]
Alimehmeti, R., Gjika, A. and Kruja, J. (2011) Orbital Emphysema after Nose Blowing. Neurology, 76, Article No. 1274. https://doi.org/10.1212/WNL.0b013e3182143523
[7]
Zachariades, N. and Mezitis, M. (1988) Emphysema and Similar Situations in and around the Maxillo-Facial Region. Revue de Stomatologie et de Chirurgie Maxillo-faciale, 89, 375-379.
[8]
Cheema, R.A., Lukaris, A.D. and Lane, C.M. (2000) Orbital Cellulitis with Gas. Orbit, 19, 41-44. https://doi.org/10.1076/0167-6830(200003)19:1;1-Z;FT041
[9]
Ong, W.C., Lim, T.C., Lim, J., et al. (2005) Cervicofacial, Retropharyngeal and Mediastinal Emphysema: A Complication of Orbital Fracture. Asian Journal of Surgery, 28, 305-308. https://doi.org/10.1016/S1015-9584(09)60367-5
[10]
Seiff, S.R. (2002) Perspective: Atmospheric Pressure Changes and the Orbit: Recommendations for Patients after Orbital Trauma or Surgery. Ophthalmic Plastic & Reconstructive Surgery, 18, 239-241. https://doi.org/10.1097/00002341-200207000-00001
[11]
Furlani, B.A., Diniz, B., Bitelli, L.G., et al. (2009) Sight-Threatening Orbital Emphysema after Nose Blowing: Case Report. Arquivos Brasileiros de Oftalmologia, 72, 251-253. (In Portuguese) https://doi.org/10.1590/S0004-27492009000200024
