Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T12:50:44.542Z Has data issue: false hasContentIssue false
  • English
  • Français

Tension pneumo-orbit treated by endoscopic, endonasal decompression: case report and literature review

Published online by Cambridge University Press:  11 February 2008

L Al-Shammari ,
A Majithia ,
A Adams  and
P Chatrath
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We present a 38-year-old man with a tension pneumo-orbit following medial orbital wall fracture, managed with endoscopic decompression.

Method:

A case report and a review of the world literature concerning the aetiology, clinical features and management of medial orbital wall fractures are presented.

Results:

Our patient presented with a post-traumatic tension pneumo-orbit exacerbated by air travel and nose-blowing. Computed tomography revealed a fracture of the ethmoid bone, and intra-orbital emphysema causing proptosis. Management with endoscopic, endonasal surgery produced excellent results, with decompression achieved and immediate and sustained improvement in visual acuity.

Conclusion:

A search of the world literature revealed no documented cases of tension pneumo-orbit as a complication of medial orbital wall fracture. Endoscopic sinus surgery is currently used in the management of nasal and sinus diseases and their orbital complications. We discuss this extended indication of endoscopic surgery, and its advantages over other surgical approaches.

Keywords

Orbital FracturesDecompressionEndoscopesOtorhinolaryngologic Surgical Procedures
Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 3 , March 2008 , e8
Copyright
Copyright © JLO (1984) Limited 2008

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.)

References

1 Lee, HM, Han, SK, Chae, SW, Hwang, SJ, Lee, SH. Endoscopic endonasal reconstruction of blowout fractures of the medial orbital walls. Plast Reconstr Surg 2002;109:872–6Google Scholar
2 Singh, M, Phua, VM, Sundar, G. Sight-threatening orbital emphysema treated with needle decompression. Clin Experiment Ophthalmol 2007;35:386–7Google Scholar
3 Monaghan, AM, Millar, BG. Orbital emphysema during air travel: a case report. J Craniomaxillofac Surg 2002;30:367–810.1054/jcms.2002.0321CrossRefGoogle ScholarPubMed
4 Smith, B, Regan, W. Blowout fractures of the obit: mechanism and correction of internal orbital fractures. Am J Ophthalmol 1957;44:733–910.1016/0002-9394(76)90774-1Google Scholar
5 Fujino, R, Experimental blowout fracture of the orbit. Plast Reconst Surg 1974;54:81–210.1097/00006534-197407000-00010CrossRefGoogle ScholarPubMed
6 Manson, PN. Pure orbital blowout fracture: new concepts and importance of the medial orbital blowout fracture. Plast Reconstr Surg 1999;104:878–82Google Scholar
7 Burm, JS, Chung, CH, Oh, SJ. Pure orbital blowout fracture: new concepts and importance of the medial orbital blowout fracture. Plast Reconstr Surg 1999;103:1839–4910.1097/00006534-199906000-00005Google Scholar
8 Cruz, AAV, Eichenberger, GCD. Epidemiology and management of orbital fractures. Curr Opin Ophthalmol 2004;15:416–2110.1097/01.icu.0000136113.56288.87CrossRefGoogle ScholarPubMed
9 Almog, Y, Mayron, Y, Weiss, J, Lazar, M, Avrahami, E. Pneumomediastinum following blowout fracture of the medial orbital wall: a case report. Ophthal Plast Reconstr Surg 1993;9:289–9110.1097/00002341-199312000-00011CrossRefGoogle ScholarPubMed
10 Tse, R, Allen, L, Matic, D. The white-eyed medial blowout fracture. Plast Reconstr Surg 2007;119:277–8610.1097/01.prs.0000237032.59094.c2CrossRefGoogle ScholarPubMed
11 Cohen, SM, Garret, CG. Pediatric orbital floor fractures: nausea/vomiting as signs of entrapment. Otolaryngol Head Neck Surg 2003;129:43–7Google Scholar
12 Burnstine, MA. Clinical recommendations for repair of orbital facial fractures. Curr Opin Ophthalmol 2003;14:236–4010.1097/00055735-200310000-00002Google Scholar
13 Sunno, T, Tahara, S, Nomura, T, Hashikawa, K. Endoscopic endonasal reduction for blowout fracture of the medial orbital wall. Plast Reconstr Surg 2003;112:1228–3710.1097/01.PRS.0000080723.29129.64CrossRefGoogle Scholar
14 Jin, HR, Yeon, JY, Shin, SO, Choi, YS, Lee, DW. Endoscopic versus external repair of orbital blowout fractures. Otolaryngol Head Neck Surg 2007;136:38–4410.1016/j.otohns.2006.08.027CrossRefGoogle ScholarPubMed
15 Yamaguchi, N, Arai, S, Mitani, H, Uchida, Y. Endoscopic endonasal technique of the blowout fracture of the medial orbital wall. Oper Techn Otolaryngol Head Neck Surg 1991;2:26910.1016/S1043-1810(10)80235-0Google Scholar
16 Jeon, SY, Kim, C, Ma, Y, Hwang, E. Microsurgical intranasal reconstruction of isolated blowout fractures of the medial orbital wall. Laryngoscope 1996;106:910–13Google Scholar
17 Jin, HR, Shin, SO, Choo, MJ, Choi, YS. Endoscopic endonasal reduction of blowout fractures of the medial orbital wall. J Oral Maxillofac Surg 2000;58:847–5110.1053/joms.2000.8199CrossRefGoogle ScholarPubMed