Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-23T07:54:21.651Z Has data issue: false hasContentIssue false
  • English
  • Français

Peri-orbital surgical emphysema following endoscopic dacryocystorhinostomy

Published online by Cambridge University Press:  21 September 2020

J C Bladen ,
W F Siah ,
P Tan ,
A S Litwin ,
S Ali  and
R Malhotra
J C Bladen
Affiliation:
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
W F Siah
Affiliation:
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
P Tan
Affiliation:
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
A S Litwin
Affiliation:
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
S Ali
Affiliation:
Department of Anaesthesia, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
R Malhotra*
Affiliation:
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
*
Author for correspondence: Mr Raman Malhotra, Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East GrinsteadRH19 3DZ, UK Fax +44 (0)1342 414106 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Peri-orbital surgical emphysema is a rare complication that can occur after lacrimal surgery. It has only been described in isolated cases, following external dacryocystorhinostomy (n = 2) and Lester Jones tube insertion (n = 1).

Method

A retrospective, non-comparative case series was conducted of patients who developed surgical emphysema following endoscopic dacryocystorhinostomy.

Results

A total of 356 endoscopic dacryocystorhinostomy cases (primary, n = 316; revision, n = 40) were performed over a six-year period. Seven cases of post-operative surgical emphysema were identified, all of which were preceded by uncontrolled sneezing, nose-blowing or coughing within the first week of surgery. The occurrence of surgical emphysema post-endoscopic dacryocystorhinostomy in our centre was 7 in 356, or 2 per cent, over six years.

Conclusion

This is the first study to report the occurrence of surgical emphysema post-endoscopic dacryocystorhinostomy. Clinicians may wish to suggest patients stifle the aforementioned triggers within the first week to reduce the potential for surgical emphysema.

Keywords

Surgical EmphysemaEndoscopic Dacryocystorhinostomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 10 , October 2020 , pp. 872 - 874
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr R Malhotra takes responsibility for the integrity of the content of the paper

References

Ghosheh, FR, Kathuria, SS. Massive subcutaneous emphysema mimicking necrotizing fasciitis after dacryocystorhinostomy. Ophthalmic Plast Reconstr Surg 2005;21:389–91CrossRefGoogle ScholarPubMed
Rodriguez, MJ, Dave, SP, Astor, FC. Periorbital emphysema as a complication of functional endoscopic sinus surgery. Ear Nose Throat J 2009;88:888–9CrossRefGoogle ScholarPubMed
Tzifa, KT, Skinner, DW. Peri-orbital surgical emphysema following functional endoscopic sinus surgery, during extubation. J Laryngol Otol 2001;115:916–17CrossRefGoogle ScholarPubMed
Parkar, A, Medhurst, C, Irbash, M, Philpott, C. Periorbital oedema and surgical emphysema, an unusual complication of a dental procedure: a case report. Cases J 2009;2:8108CrossRefGoogle ScholarPubMed
Colemont, LJ, Pelckmans, PA, Moorkens, GH, Van Maercke, YM. Unilateral periorbital emphysema: an unusual complication of endoscopic papillotomy. Gastrointest Endosc 1988;34:473–5CrossRefGoogle ScholarPubMed
Zimmer-Galler, IE, Bartley, GB. Orbital emphysema: case reports and review of the literature. Mayo Clin Proc 1994;69:115–21CrossRefGoogle ScholarPubMed
Abdesslem, K, Sondes, B, Wael, E, Hajer, T, Morched, D, Fathi, K et al. A case of post-traumatic severe orbital emphysema: case report and literature review [in French]. J Fr Ophtalmol 2014;37:e165–7CrossRefGoogle Scholar
Malhotra, R, Norris, JH, Sagili, S, Al-Abbadi, Z, Avisar, I. The learning curve in endoscopic dacryocystorhinostomy: outcomes in surgery performed by trainee oculoplastic surgeons. Orbit 2015;34:314–19CrossRefGoogle Scholar
Patel, V, Ross, JJ, Malhotra, R. Early experience using a new modified bone nibbler for superior osteotomy during endonasal dacryocystorhinostomy. Ophthalmic Plast Reconstr Surg 2011;27:15–20CrossRefGoogle ScholarPubMed
Lima, V, Burt, B, Leibovitch, I, Prabhakaran, V, Goldberg, RA, Selva, D. Orbital compartment syndrome: the ophthalmic surgical emergency. Surv Ophthalmol 2009;54:441–9CrossRefGoogle ScholarPubMed
Sultan, H, Malik, A, Li, HK, Chevez-Barrios, P, Lee, AG. Necrotizing fasciitis of the periorbital region complicated by combined central retinal artery occlusion, central retinal vein occlusion, and posterior ciliary occlusion. Ophthalmic Plast Reconstr Surg 2017;33:e75–6CrossRefGoogle ScholarPubMed