Orbital emphysema following remote skull trauma

Retrobulbar Orbital Emphysema Associated With Medial Orbital Wall Fracture

Retrobulbar emphysema is a rare condition compared to the more common orbital emphysema. It is often associated with medial orbital wall fracture with rupture of the periosteum. In some severe patients, retrobulbar emphysema can increase the intraorbital pressure and lead to orbital compartment syndrome. Less extreme patients require only conservative treatment with careful observation. There is still no standard protocol for the management of orbital emphysema in general or specifically for retrobulbar emphysema. Visual acuity is the most widely used indicator to determine whether surgical intervention is needed. The patient presented here suffered from large retrobulbar intraconal emphysema and exophthalmos without visual loss after head trauma and nose blowing. He was observed closely without surgical intervention. After the emphysema had resolved, the patient's medial orbital wall defect was reconstructed using unsintered hydroxyapatite particles/poly L-lactide via the transcaruncular approach. The postoperative course has been uneventful with more than 1 year of follow-up to date.

Orbital Subcutaneous Emphysema in a Child

The authors present a rare case of nontraumatic medial orbital wall fracture in an 11-year-old girl. Fractures of the orbital wall secondary to nose blowing have not been previously described in the pediatric population. The patient reported a history of chronic forceful nose blowing, followed by periorbital swelling after an episode of vigorous nose blowing. Erroneous diagnoses of sinusitis and periorbital cellulitis lead to unnecessary antibiotic treatment. The authors hypothesize that repeated and aggressive nose blowing is analogous to stress fractures, leading to weakening and eventual fracture of the medial orbital wall.

Orbital emphysema after a protracted episode of sneezing in a patient with no history of trauma or sinus surgery

Orbital emphysema is a benign self-limiting condition. It can occur directly (as a result of trauma to the face) or indirectly (secondary to a blowout fracture). We report a case of orbital emphysema in a 38-year-old man who presented with ecchymosis of the right eye, pressure within the right orbit, and periorbital swelling following a protracted episode of vigorous sneezing. The diagnosis was confirmed by computed tomography. Systemic antibiotics were given, and the patient was cautioned to avoid blowing his nose. His signs and symptoms resolved within 1 week.

Spontaneous orbital subcutaneous emphysema after sneezing

Orbital subcutaneous emphysema develops when air enters the surrounding soft tissue. This occurs as a result facial bone trauma, iatrogenic dental and otolaryngeal procedures, and gas-producing infectious microorganisms. Case reports regarding this phenomenon after sneezing are very uncommon. Although orbital subcutaneous emphysema is not a true emergency, it can be distressful to patients. This case serves to bring awareness to emergency department physicians regarding the possibility of a nontraumatic orbital subcutaneous emphysema and its related complications.

A case of orbital emphysema associated with internal laryngocele

Orbital emphysema (OE) is usually the result of a fracture of lamina papyrecea or maxillary roof allowing air to pass from the sinuses into the orbit. OE without evidence of any significant trauma is a rare occurrence. Thorough literature search revealed that no case of OE due to the rupture of internal laryngocele has been reported. A case is reported here of bilateral orbitopalpebral emphysema associated with internal laryngocele, in the absence of facial skeleton trauma, in a healthy young adult male. It should be kept in mind that laryngocele rupture would be one of the underlying causes of OE or OE would be the presenting symptom of laryngocele rupture.