A hearty sneeze

Roselle, Harry A; Herman, Marc

doi:10.1016/s0140-6736(10)61161-0

Cited by 4 publications

(6 citation statements)

References 1 publication

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“…The sites of injury were classified according to anatomical location: ocular/orbital [3][4][5][6][7][8][9][10][11][12][13][14][15] (27%), intrathoracic [16][17][18][19][20][21][22][23][24][25][26][27][28] (25%), intercranial/neurological 29-38 (19%), laryngeal/pharyngeal [39][40][41][42][43][44][45] (13%), otologic [46][47][48] (6%), and other [49][50][51][52][53] (10%) ( Figure 1). There were 15 cases orbital/ocular injury: orbital subcutaneous emphysema [3][4][5][6][7]10,11,…”

Section: Resultsmentioning

confidence: 99%

The Dangers of Sneezing: A Review of Injuries

Setzen

Platt

2019

Am J Rhinol�Allergy

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Background Sneezing is an almost universal daily phenomenon as a reflex to evacuate irritants from the nasal cavities. An autonomic-controlled buildup of intrathoracic pressure against a closed glottis followed by sudden release results in a burst of 1 kPa of air through the upper airway. Active intervention to limit a sneeze can be deleterious. Closure of the airway during a sneeze can result in over 20 times the airway pressures resulting in a variety of untoward events. This review summarizes all reported injuries that occurred as the result of a sneeze. Objective The objective of this review is to summarize the risks of closed-airway sneezing and determine if there are any trends which can help understand such injuries. Methods A comprehensive literature review was performed from 1948 to 2018 to identify all reports of sneeze-related injuries. Information was compiled from reports to gain insights into comorbidities and risk factors for sneeze injuries. Results There were 52 unique reports of sneeze-related injuries in the literature that were categorized into 6 areas of injury: intrathoracic, laryngeal/pharyngeal, ocular/orbital, intracranial/neurological, otologic, and other. The mean age of subjects who suffered a sneeze injury was 40 years old (range: 15–84 years), with 81% being male gender. Thirty percent had a risk factor for injury of prior trauma (5) or respiratory compromise (5). Conclusion A variety of injuries can occur during a sneeze, especially when a closed-airway sneeze is attempted, and high Valsalva pressure is transmitted to the other systems. Men are more at risk for these injuries with the majority occurring in patients with no known risk factor. When triggered, a sneeze should be allowed to proceed without intervention to prevent associated injuries.

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Section: Resultsmentioning

confidence: 99%

The Dangers of Sneezing: A Review of Injuries

Setzen

Platt

2019

Am J Rhinol�Allergy

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“…Although severe consequence like blindness is possible, orbital emphysema is generally benign and self-limited, most associated with orbital fracture involving paranasal sinuses. 1 Other causes include but are not limited to pulmonary barotrauma, infection, conjunctival laceration, and oral and otorhinolaryngeal procedures. 1 , 5 Roselle and Herman 1 reported a case with no aforesaid conditions but a possibly undetectable anatomical defect.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Other causes include but are not limited to pulmonary barotrauma, infection, conjunctival laceration, and oral and otorhinolaryngeal procedures. 1 , 5 Roselle and Herman 1 reported a case with no aforesaid conditions but a possibly undetectable anatomical defect. Few authors mentioned tumor as an etiology, except Cecire et al's 3 reported case indicating a possible association of ethmoid osteoma with orbital emphysema and orbital cellulitis, and Jack et al's 4 reported case of frontal sinus osteoma presenting with orbital emphysema after nasal blunt trauma.…”

Section: Discussionmentioning

confidence: 99%

“…It is usually benign and self-limited, but can lead to ophthalmic emergencies like ischemic optic neuropathy and central retinal artery occlusion. 1 , 2 The recognition about its etiology has extended beyond sole trauma, but few articles mentioned tumors to be a possible cause. Cecire et al 3 reported a case of ethmoid osteoma associated with orbital cellulitis and orbital emphysema.…”

Section: Introductionmentioning

confidence: 99%

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Ethmoid Osteoma as a Culprit of Orbital Emphysema

Zhuang

Lin

et al. 2015

Medicine

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Orbital emphysema is generally recognized as a complication of orbital fractures involving any paranasal sinuses. The recognition about its etiology has extended beyond sole trauma, but few articles mentioned tumors to be a possible cause.In this case report, we present a patient with orbital emphysema associated with ethmoid osteoma without orbital cellulitis or trauma history. The patient developed sudden proptosis, eyelid swelling, and movement limitation of the left eye, peripheral diplopia, and left periorbital crepitus after a vigorous nose blowing.Complete surgical resection of ethmoid osteoma followed by repair of the orbital medial wall was performed with assistance of combined endoscopy and navigational techniques. Twelve-month follow-up showed no residual lesion or recurrence; the orbital medial wall was accurately repaired with good visual function and facial symmetry.Tumors should be considered for differential diagnosis of orbital emphysema, and combined endoscopy and navigational techniques may improve safety, accuracy, and effectiveness of orbital surgeries.

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“…A human parallel with the thin outer lip of the cetacean tympanic bulla involves the thin area of the bone at the orbital wall, the lamina papyracea. The lamina may be fractured by sneezing, resulting in orbital emphysema with swelling, bleeding, and presence of orbital air (Roselle & Herman, ). Yet, this hypothesis is difficult to evaluate for cetaceans, whose respiration is under voluntary control.…”

Section: Discussionmentioning

confidence: 99%

Extensively remodeled, fractured cetacean tympanic bullae show that whales can survive traumatic injury to the ears

et al. 2015

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Underwater human activities and anthropogenic noise in our oceans may be a major source of habitat degradation for marine life. This issue was highlighted by the opening of the United States Eastern Seaboard for seismic oil and gas exploration in 2014, which generated massive media coverage and widespread concern that seismic surveys could kill or deafen whales. We discovered 11 new specimens of fractured and healed cetacean ear bones, out of a survey of 2127 specimens housed in museum collections. This rare condition has been previously reported only in two specimens of blue whales (Balaenoptera musculus) from the early 1900s, summarized by Fraser & Purves (1953). All of our new specimens are represented by species for which this condition had never been reported previously, including both baleen and toothed whales. The baleen whale specimens (Balaenoptera physalus, Balaenoptera borealis, Balaenoptera acutorostrata) were collected during Canadian commercial whaling operations in the Atlantic Ocean in the 1970s; the specimens include ear bones with well-healed fractures, demonstrating that baleen whales are capable of overcoming traumatic injury to the ears. The toothed whale specimens (Delphinus sp., Berardius bairdii) were found dead on beaches in 1972 and 2001, respectively, with less remodeled fractures. Thus, ear injuries may be more lethal to the echolocating toothed whales, which rely on hearing for navigation and foraging. We explore several hypotheses regarding how these injuries could have occurred, and conclude that the most parsimonious explanations appear to be both direct and indirect effects of lytic processes from disease or calcium depletion, or damage from external pressure waves. Although further research is required to confirm whether the fractures resulted from natural or human-induced events, this study underscores the importance of museum collections and the work of stranding networks in understanding the potential effects of modern human activities on marine mammal health.

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A hearty sneeze

Cited by 4 publications

References 1 publication

The Dangers of Sneezing: A Review of Injuries

The Dangers of Sneezing: A Review of Injuries

Ethmoid Osteoma as a Culprit of Orbital Emphysema

Extensively remodeled, fractured cetacean tympanic bullae show that whales can survive traumatic injury to the ears

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