Orbital emphysema with orbital floor blow-out fracture.
He was treated conservatively and discharged with explanation of it
might expected to resolve spontaneously. He was instructed to avoid
blowing his nose and any other activities that may lead to increased
pressure in the nasal cavity, including diving or flying.
Discussion
Cases of spontaneous orbital emphysema caused by non-traumatic reasons
are very rare.1 Rapid increase in pressure in the
upper airways during sneezing, coughing, nose blowing is related to
barotrauma which very rarely leads to orbital wall fracture. The
pressure evoked by forceful nose blowing rises to 66 mmHg, as estimated.
Sneezing with the oral and nasal passages blocked may evoke a pressure
up to 176 mmHg.2 Orbital emphysema without
complication usually resolves spontaneously within 2 weeks.