Periorbital Air Following Sneeze: Case Report

Yıl 2019, Cilt: 1 Sayı: 3, 125 - 128, 23.12.2019

Yağmur Gökhan Semerci Cesareddin Dikmetaş Ayla Köksal Dilek Atik Serkan Doğan Duygu Yaman Başar Cander

Öz

Introduction
Air’s presence in orbit,periorbital tissues is called orbital emphysema.Aim of report was to present cases who developed periorbital emphysema following sneezing after impact onto the nose. 
Case 1: 
46-years old female patient referred Emergency Room (ER)due to swelling on left eye.She was hit onto nose by her child.She squeeze nose,closed nostrils during sneezing.She felt blood;left eye was swollen,she had temporary vision loss.Left eye was swollen,closed due to edema,crepitation is detected on the left upper eyelid;vision was normal,light reflex(LR)was positive.According to maxillofacial computer tomography,free air densities on left periorbital area,edematous appearance were detected;left nasolacrimal channel was prominent due to air.Otorhinolaryngologist performed endoscopic examination,identified hemorrhagic spotting on left meatus of orbit;bleeding wasn’t detected,patient’s treatment was planned in consultation with otorhinolaryngology,ophthalmology clinics;she was advised not to blow nose fast,to sneeze with open mouth.
Case 2: 
45-years old male patient referred ER due to swelling on left eye.He hit nose on wall;he closed nostrils during sneezing,eyes swell.Left eye was swollen,closed due to edema;crepitation was detected on left lower eyelid;he had normal vision with a positive LR.Maxiofacial computer tomography scan was performed; free air densities were detected in left periorbital area,left maxillary sinus roof was detected broken.Consultation was performed with otorhinolaryngology,ophthalmology clinics.Consultants recommended medical treatment,outpatient follow-up.
Conclusion
Air may leak around the eye due to trauma after sneezing while the mouth is closed following any trauma onto the nose,other face regions.The emergency physicians should be aware that such air has a benign progress,may be treated by antibiotics; they should arrange consultations,follow-ups with ophthalmology clinics.

Anahtar Kelimeler

Emphysema, Periorbital Air, , Sneeze

Kaynakça

• Referans1- Şahin L. Hapşırırken Ağzın Kapatılması Sonrası Orbital AmfizemOlgusu.İnönüÜniversitesiSağlıkHizmetleriMeslekYüksekokuluDergisi, 2019; 7(1): 122-124.
• Referans2-Ord RA, Le May M, Duncan JG, Moos KF. Computerized tomography and B-scan ultrasonography in the diagnosis of fractures of the medial orbital wall. Plas tReconstr Surg 1981;67(3):281-8.
• Referans3-Papadimitriou P, Ntomouchtsis A, Antoniades K. Delayed traumatic ocular emphysema: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:e18-20.Referans4-Mohan B, Singh KP.Bilateral subcutaneous emphysema of the orbits following nose blowing. J Laryngol Otol 2001;115:319-20
• Refrans5-Benharbit M, Karim A, Lazreq M, Mohcine Z.[Emergency treatment of post-traumatic orbital emphysema: a case report]. J Fr Ophtalmol2003;26(9):957-9.
• Referans6-Silver HS, Fucci MJ, Flanagan JC, Lowry LD. Severe orbital infection as a complication of orbital fracture. Arch Otolaryngol Head Neck Surg 1992;118(8):845-8.
• Referans7-Gwaltney JM JR, Hendley JO, Phillips CD, Bass CR, Mygind N, Winther B. Nose blowing propels nasal fluid into the paranasal sinuses. Clin Infect Dis, 2000; 30(2): 387-91.
• Referans8-Dobler AA, Nathenson AL, Cameron JD, Carpel ET, Janda AM, Pederson JE.A case of orbital emphysema as an ocular emergency. Retina 1993; 13(2): 166-8.
• Referans9-Sheele, J., & Lang, J. (2016).A Rare Case of Traumatic Tension Pneumo-orbitum.Emerg Med, 48(8), 357-361.
• Referans10- Oba E.,PamukcuC,Erdenöz S.Birol, travmatik orbital amfizemlereyaklaşım.Ulus TravmaAcilCerrahiDerg 2011;17 (6):570-572.