Retrobulbar Orbital Emphysema Associated With Medial Orbital Wall Fracture. Issue 5 (July 2019)

• Record Type: Journal Article
• Authors: Dong, Quang Ngoc; Ide, Taichi; Karino, Masaaki; Okuma, Satoe; Koike, Takashi; Kanno, Takahiro
• Is Part Of: Journal of craniofacial surgery. Volume 30:Issue 5(2019)
• Publication Date: 2019-07
• Subjects: Conservative treatment -- medial orbital wall fracture -- retrobulbar emphysema -- transcaruncular approach -- unsintered hydroxyapatite particle/poly L-lactide; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000005390
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Abstract: Retrobulbar emphysema is a rare condition compared to the more common orbital emphysema. It is often associated with medial orbital wall fracture with rupture of the periosteum. In some severe patients, retrobulbar emphysema can increase the intraorbital pressure and lead to orbital compartment syndrome. Less extreme patients require only conservative treatment with careful observation. There is still no standard protocol for the management of orbital emphysema in general or specifically for retrobulbar emphysema. Visual acuity is the most widely used indicator to determine whether surgical intervention is needed. The patient presented here suffered from large retrobulbar intraconal emphysema and exophthalmos without visual loss after head trauma and nose blowing. He was observed closely without surgical intervention. After the emphysema had resolved, the patient's medial orbital wall defect was reconstructed using unsintered hydroxyapatite particles/poly L-lactide via the transcaruncular approach. The postoperative course has been uneventful with more than 1 year of follow-up to date. Abstract : Supplemental Digital Content is available in the text