創傷性眼眶氣腫

Traumatic Orbital Emphysema

李正熙(Cheng-Hsi Li) ； 林鴻清(Hung-Ching Lin) ； 徐銘燦(Min-Tsan Shu)

《台灣耳鼻喉頭頸外科雜誌》 41卷5期 (2006/10) Pp. 169-172

https://doi.org/10.6286/2006.41.5.169

摘要

眼眶氣腫是一為人所熟知但臨床上罕見的疾病。最常見的原因是創傷造成眼眶骨骨折或缺損，導致氣體由鼻竇進入眼眶滯留；其它原因包括感染、高壓氣體衝擊、肺因性高壓及手術併發症。一般而言，眼眶氣腫病程進展多半為自限性且預後良好，但仍有少數失明的案例報告。本文提出1名因擤鼻造成眼眶浮腫的病例。患者4天前臉部受到他人手肘撞擊，病人於求診時發現其右側眼皮腫脹但視力正常，無眼球運動受限及眼球內陷；觸診發現有捻髮聲(crepitation)。經電腦斷層影像檢查，可發現右側眼眶內壁骨折合併眼眶氣腫。經2週保守性治療且衛教病人不可用力擤鼻後，眼眶氣腫幾乎完全消失。追蹤5個月並無復發或其他併發症。

關鍵字

眼眶氣腫 ； 皮下氣腫 ； 眼球內陷

並列摘要

Orbital emphysema is a well described, yet relatively uncommon clinical manifestation. Accumulation of air within the eyelids or orbit is most commonly associated with trauma and the fracture of one of the orbital bones. Other causes included infection, compressed air, pulmonary barotrauma and surgical complication. Although orbital emphysema is generally a benign self-limitting condition, there have been a few reports of blindness as a consequence of the disease. Here we describe a patient who developed orbital and subcutaneous emphysema after forceful sneezing. The patient had a history of trauma, which occurred when she was hit in the face by someone, s elbow four days earlier. At our out-patient department, the patient presented with right eyelid swelling. Visual acuity was not impaired. There was no limitation of extraocular movement and also no enophthalmos. Computer tomography revealed a rupture of the lateral wall of right posterior ethmoid sinus with free air leakage into right orbital region. The patient received conservative treatment and was instructed to avoid sneezing. The orbital emphysema had completely resolved two weeks later. She has been follow up for five months without any recurrence or complications.

並列關鍵字

orbital emphysema ； subcutneous emphysema ； enophthalmos