Skip to main content
Journal of Emergencies, Trauma, and Shock logoLink to Journal of Emergencies, Trauma, and Shock
letter
. 2015 Jul-Sep;8(3):172–173. doi: 10.4103/0974-2700.145409

An unexpected complication of sneezing: Blow-out orbital fracture

Pınar Yeşim Akyol 1, Erden Erol Ünlüer 1, Orhan Oyar 1, Serkan Bilgin 1
PMCID: PMC4520035  PMID: 26229305

Dear Editor,

Blow-out fracture is characterized by a damage to the orbital walls with intact orbital margins and bone fragments displaced outside the orbit. The common mechanism of injury for a orbital fracture is blunt trauma to the orbit or forehead.[1] A 32-years-old man was brought to our emergency department with a swollen condition on his right orbita which began after sneezing. He had horizontal diplopia and crepitus as a sign of periorbital emphysema. Computed tomography scan revealed blow-out fracture on the medial wall of right orbita image, extra conala dipose tissue protruded partially to the superior oblique muscle and free air inside the soft tissue areas [Figures 1 and 2].

Figure 1.

Figure 1

Blow-out fracture is seen on the medial wall of right orbita image and free air inside the soft tissue areas

Figure 2.

Figure 2

On the medial wall of orbita, extraconal adipose tissue protrudes partially to the superior oblique muscle and free air inside the soft tissue areas

Clinical symptoms of orbital fracture are diplopia, enophthalmos, or restriction of gaze.[2] Orbital emphysema without impaired vision is not a life-threatening condition and usually resolves spontaneously within 2 weeks. Cases of spontaneous orbital emphysema caused by sneezing, cough, or nose blowing are very rare.

REFERENCES

  • 1.Rzymska-Grala I, Palczewski I, Blaz M, Zmorzyński M, Gołębiowski M, Wanyura H. A peculiar blow-out fracture of the inferior orbital wall complicated by extensive subcutaneous emphysema: A case report and review of the literature. Pol J Radiol. 2012;77:64–8. doi: 10.12659/pjr.882973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Kunz C, Sigron GR, Jaquiéry C. Functional outcome after non-surgical management of orbital fractures — the bias of decision-making according to size of defect: Critical review of 48 patients. Br J Oral Maxillofac Surg. 2013;51:486–92. doi: 10.1016/j.bjoms.2012.09.016. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Emergencies, Trauma, and Shock are provided here courtesy of Wolters Kluwer -- Medknow Publications

RESOURCES