Orbital emphysema after nose blowing

Abstract

A 36-year-old man, a heavy smoker with chronic allergic rhinitis, awoke with a blocked nose. When blowing the left nostril, keeping the right one blocked, there was sudden pain over his right eye with ptosis (figure 1). Palpation over the right eyelid revealed crepitations; X-ray and CT scan (figure 2, A and B) showed air over the medial wall of the right orbit. Orbital emphysema may be due to injury.1 Similar cases with spontaneous recovery have been reported. 2 We advised him not to blow his nose vigorously and to use physiologic water for nasal rinsing, followed by nasal decongestant. The ptosis resolved in 2 weeks.

Barotraumatic Subcutaneous Orbital Emphysema after Nose Blowing: Case Report

“…But rarely as in our case, might intraorbital barotrauma be the sole mechanism that results in the subcutaneous air. The intraorbital pressure rise can be observed during nose blowing, sneezing, coughing, vomiting, diving or travelling by plane [1][2][3][4].…”

“…There are a few spontaneous orbital emphysema cases reported in the literature. The mechanism is defined with sudden increase in the intraorbital pressure [1][2][3][4][5].…”