An Idiopathic Recurrent Bilateral Orbital Emphisema Case Report

Abstract

A 17-year old female applied with acute bilateral swelling in her eyelids with no trauma history or previous medical disorder. She mentioned in last 9 months, this situation occurred very often: Acute onset of bilateral swelling and spontaneous recovery in a few days.

Severe bilateral periorbital swelling and subcutaneous crepitations without ecchymosis was seen. Body temperature, eye movements, reactions of pupils in light were normal. No proptosis and diplopia were noted. Visual aquity (VA) in right eye could not be determined but the VA of lelf eye was full. Anterior and posterior segments were seen normal. In orbital computerized tomography (CT) bilateral intraorbital and preseptal emphysema were remarkable. No fracture line was detected. The patient was accepted as preseptal cellulitis and treatment was arranged.

After 3 days it was seen that the swelling in left eye was lessened and interpalpebral aperture was noticable. However right eye’s condition was  the same. Control orbital CT was also same. Clinical partial recovery in left eye was accepted significant and present treatment was maintained. In second control visit, no further recovery findings were remarkable. Routine blood tests were normal except for immunoglobulin E (IgE).

Most common reasons of orbital emphysema are severe sneezing, nose blowing or occult minor periorbital traumas. But in this case none of these had happened.

Nontraumatic orbital emphysema is a benign disorder which rarely proceeds with complications and has no responce to systemical therapy. Even if it is bilateral and recurrent, because it heals spontaneously, it is appropriate to follow these cases without giving systemical treatment.

Key Words: Bilateral, Recurrent, Orbital Emphysema, Orbita, Emphysema