Orbital and Intracranial Emphysema Causing Orbital Compartment Syndrome: A Rare Case Report and Literature Review
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CLINICAL REPORT
Orbital and Intracranial Emphysema Causing Orbital Compartment Syndrome: A Rare Case Report and Literature Review Ankur K. Shrivastava1 • Santhosh Rao2 Sruthi Rao3 • Mary Anto1
•
Swatishree Nayak1
•
Received: 31 July 2020 / Accepted: 20 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract A case of 50-year-old male who presented with orbital compartment syndrome as a sequela of mid facial trauma, and literature review. Orbital compartment syndrome (OCS) is one of the potentially sight threatening emergencies encountered in clinical practice. Acute rise in pressure within the confined orbital cavity compromises the blood flow to retina and optic nerve leading to irreparable vision loss. Air entrapped in the orbital cavity leading to orbital compartment syndrome has been rarely reported. A brief literature search for the term orbital emphysema in PubMed yielded 352 articles out of which 280 articles were identified after screening for appropriate titles and case reports. A total of 138 patients were reported in the literature with severe orbital emphysema. Acute orbital compartment syndrome needs to be recognized and addressed on an emergency basis to achieve decompression so as to prevent an irreversible vison loss. Watchful eyes, & Santhosh Rao [email protected]; [email protected] Ankur K. Shrivastava [email protected] Swatishree Nayak [email protected]
an accurate diagnosis and timely surgical intervention could potentially reverse permanent damage to the optic nerve. Keywords Orbital compartment syndrome Orbital emphysema Lateral canthotomy
Introduction Orbital compartment syndrome (OCS) following repair of a fracture zygoma was initially described by Gordon and McCrae in 1950 [1]. Acutely increased intraorbital pressure beyond the systemic pressure shall lead to increased intracompartment pressure which leads to hypoperfusion and subsequent ischemia affecting the optic nerve and retinal function which may lead to irreversible loss of vision [2]. Retrobulbar haemorrhage secondary to orbital or facial trauma has been described as the most common cause of OCS followed less commonly by ophthalmic surgical trauma, peribulbar or retrobulbar injections, orbital emphysema and non-ophthalmic procedures such as craniofacial surgery, sinus surgery and neurosurgery. The present report describes an unusual case of OCS due to traumatic tension orbital emphysema (OE).
Sruthi Rao [email protected] Mary Anto [email protected]
Case
1
Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, India
2
Oral and Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Raipur, India
3
Department of Oral and Maxillofacial Surgery, Rungta College of Dental Sciences and Research, Bhilai, India
A 50-year-old male presented to the out-patient department two hours following road traffic accident. The patient had history of loss of consciousness along with nasal bleed, one bout of vomiting and history o
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