An unexpected complication of sneezing: Blow-out orbital fracture.

Dear Editor,

Blow-out fracture is characterized by a damage to the orbital walls with intact orbital margins and bone fragments displaced outside the orbit. The common mechanism of injury for a orbital fracture is blunt trauma to the orbit or forehead.[1] A 32-years-old man was brought to our emergency department with a swollen condition on his right orbita which began after sneezing. He had horizontal diplopia and crepitus as a sign of periorbital emphysema. Computed tomography scan revealed blow-out fracture on the medial wall of right orbita image, extra conala dipose tissue protruded partially to the superior oblique muscle and free air inside the soft tissue areas [Figures 1 and 2].

Figure 1

Blow-out fracture is seen on the medial wall of right orbita image and free air inside the soft tissue areas

Figure 2

On the medial wall of orbita, extraconal adipose tissue protrudes partially to the superior oblique muscle and free air inside the soft tissue areas

Clinical symptoms of orbital fracture are diplopia, enophthalmos, or restriction of gaze.[2] Orbital emphysema without impaired vision is not a life-threatening condition and usually resolves spontaneously within 2 weeks. Cases of spontaneous orbital emphysema caused by sneezing, cough, or nose blowing are very rare.