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Journal Information
Vol. 67. Issue 4.
Pages e28-e29 (July - August 2016)
Vol. 67. Issue 4.
Pages e28-e29 (July - August 2016)
Images in Otorhinolaryngology
DOI: 10.1016/j.otoeng.2016.07.003
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Orbital Emphysema After Blowing the Nose
Enfisema periorbitario tras sonarse la nariz
Frank Alberto Betances Reinoso
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Corresponding author.
, Carlos Miguel Chiesa Estomba, Alejandra Osorio Velasquez
Servicio de Otorrinolaringología, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
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A male patient aged 19 with no clinical history of interest, went to the emergency services after presenting with an increased volume in the right eye area of sudden appearance, after blowing his nose (Fig. 1). Examination revealed that there was crackling at the level of both eyelids. Both rhinoscopy and endoscopy reported completely normal results. The patient was assessed by the ophthalmology department, denied any pain on making eye movements, had good visual sharpness and the back of the eye was normal. A CT scan was performed (Figs. 2 and 3) where dehiscence of right lamina papyracea was noted, with minimal medial displacement, and with occupation of neighbouring ethmoidal cells from soft tissue high density material. There was general right periorbital pneumatosis, with gas bubbles at orbital nasal face level, orbital floor, temporal face level, in the upper region when raising the eyelid and at the upper and lower palpebral level. The eyeball was intact and correctly positioned. There were no notable changes in orbital musculature. We decided to adopt a conservative approach and the swelling subsided spontaneously.


Periorbital emphysema is normally associated with facial trauma, especially when this involves the eyeball, and with surgical procedures which may lead to a fracture over the orbital wall, but in up to 0.8% of patients there may be a dehiscent lamina papyracea. This is caused by the passing of air from the paranasal sinuses to the periorbital space and to the structures comprising the eyeball. Periorbital emphysema with no prior history of trauma or surgery is a very rare condition which usually resolves itself spontaneously.

Conflict of Interests

The authors have no conflict of interests to declare.

Please cite this article as: Betances Reinoso FA, Chiesa Estomba CM, Osorio Velasquez A. Enfisema periorbitario tras sonarse la nariz. Acta Otorrinolaringol Esp. 2016;67:e28–e29.

Copyright © 2015. Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello
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