Cervicofacial, Retropharyngeal and Mediastinal Emphysema: A Complication of Orbital Fracture

Abstract

Retropharyngeal and mediastinal emphysema is associated with traumatic aerodigestive tract injury, and may be associated with potentially severe and even life-threatening complications. Retropharyngeal emphysema or pneumomediastinum, in the absence of severe trauma to the visceral organs, is rare following facial fractures. We report a case of extensive subcutaneous emphysema extending to the retropharyngeal space and mediastinum following an orbitozygomatic fracture.

Periorbital and mediastinal emphysema after upper gastrointestinal endoscopy: Case report of a rare complication

“…Orbital and cervicofacial emphysema extending into the mediastinum have been reported following orofacial trauma including fractures, compressed air injuries, and dental procedures involving the use of high speed air-driven hand pieces. [3567] Similarly pneumomediastinum, pneumoperitoneum, and subcutaneous emphysema are known complications following procedures such as upper endoscopy, endoscopic retrograde cholangiopancreatography (ERCP), and colonoscopy, and can occur with or without perforation. [8910] Pathophysiology of these complications is explained by the anatomical connections between the deep neck fascia, mediastinum, and retroperitoneum, and continuous air insufflations during procedures such as ERCP.…”

Subcutaneous Emphysema, Pneumo-Orbita and Pneumomediastinum Following a Facial Trauma Caused by a High-Pressure Car Washer

“…[3,10] Traumatic pneumomediastinum, on the other hand, develops as a consequence of external head, neck, and thoracic traumas as well as iatrogenically with invasive medical procedures such as esophagoscopy, bronchoscopy, endotracheal intubation, and tooth extraction. [1,[10][11][12][13][14] Pneumomediastinum following cervicofacial emphysema is very rare and has been reported after orofacial trauma, head and neck surgery, or dental surgical procedures. [11][12][13][14][15][16] Orbital trauma leading to periorbital subcutaneous emphysema extending to neck and mediastinum is a very rare occurrence.…”

“…[1,[10][11][12][13][14] Pneumomediastinum following cervicofacial emphysema is very rare and has been reported after orofacial trauma, head and neck surgery, or dental surgical procedures. [11][12][13][14][15][16] Orbital trauma leading to periorbital subcutaneous emphysema extending to neck and mediastinum is a very rare occurrence. [17] During isolated facial trauma, air may be forcefully introduced into the parapharyngeal and retropharyngeal spaces, follow the potential space at the prevertebral and fascial planes, and can lead to emphysema in the neck and mediastinum.…”

A Retrospective Audit of Hundred Patients of Orbitozygomatic Fractures with Brain Injury

“…Ong WC [19] reported Cervicofacial, retropharyngeal and mediastinal emphysema (a rare complication) after orbital fractures. Traumatic brain injury concomitant with facial fractures is another common occurrence.…”