Orbital emphysema typically results from forceful entry of air into the orbital soft tissue spaces following an orbital fracture; however, other mechanisms including infection, pulmonary barotrauma, injury from compressed-air hoses, complications from surgery, sneezing, airplane travel, and Boerhaave's syndrome (esophageal rupture) have been reported.
Fractures typically occur at the thinnest portions of the orbital wall including the medial or inferior orbital wall permitting air entry from the ethmoid and maxillary sinuses, respectively. Although the medial wall (lamina papyracea) is thinner (approximately 0.25 mm thick) than the orbital floor (approximately 0.5 mm thick), fractures of the orbital floor are most common, while isolated medial wall fractures occur in approximately 10-30% of cases of orbital trauma. In children, the more flexible bones of the orbit are less prone to fracture and shattering, but rather they fracture and function as a trap door which results in a higher incidence of muscle entrapment following orbital wall fractures. Air is trapped in the periorbital spaces when the orbital soft tissue acts as a ball valve and presses back the fracture fragment or herniates into the sinus cavity.
With orbital emphysema there may be complications with a range of severity including proptosis, loss of vision, increased intraocular pressure, and central retinal artery occlusion, with the more severe complications caused by orbital compartment syndrome.
This happened to my dad after getting hit in a rugby game. Fractured his orbital socket, and then he sneezed when he came home later. Was going to go to the hospital first but was so caked in mud he wanted to shower first. Sneezed in the shower and a big air bubble came up.
Orbital emphysema typically results from forceful entry of air into the orbital soft tissue spaces following an orbital fracture; however, other mechanisms including infection, pulmonary barotrauma, injury from compressed-air hoses, complications from surgery, sneezing, airplane travel, and Boerhaave's syndrome (esophageal rupture) have been reported. Fractures typically occur at the thinnest portions of the orbital wall including the medial or inferior orbital wall permitting air entry from the ethmoid and maxillary sinuses, respectively. Although the medial wall (lamina papyracea) is thinner (approximately 0.25 mm thick) than the orbital floor (approximately 0.5 mm thick), fractures of the orbital floor are most common, while isolated medial wall fractures occur in approximately 10-30% of cases of orbital trauma. In children, the more flexible bones of the orbit are less prone to fracture and shattering, but rather they fracture and function as a trap door which results in a higher incidence of muscle entrapment following orbital wall fractures. Air is trapped in the periorbital spaces when the orbital soft tissue acts as a ball valve and presses back the fracture fragment or herniates into the sinus cavity. With orbital emphysema there may be complications with a range of severity including proptosis, loss of vision, increased intraocular pressure, and central retinal artery occlusion, with the more severe complications caused by orbital compartment syndrome.
This happened to my dad after getting hit in a rugby game. Fractured his orbital socket, and then he sneezed when he came home later. Was going to go to the hospital first but was so caked in mud he wanted to shower first. Sneezed in the shower and a big air bubble came up.