Orbital emphysema: how common, how significant?
OBJECTIVE
To describe the natural history of orbital emphysema and its management in the emergency setting.


METHODS
Retrospective medical record review.


METHODS
Inner-city integrated hospital system (four divisions) including one Level I trauma center.


METHODS
All cases of orbital floor fracture and orbital emphysema from January 1, 1988, to December 31, 1993.


RESULTS
The average patient was aged 33 years, and the male-to-female ratio was 7 to 1. Trauma was the underlying etiology in all patients. Seventy-four percent of patients required hospitalization, and 43% developed significant complications. Eighty-three percent were managed with antibiotics. Orbital emphysema was identified on conventional radiographs in 65% of cases.


CONCLUSIONS
Identification of orbital emphysema in the ED should prompt a careful search for associated injury. Consultation should be sought in the presence of orbital or ocular injury. Antibiotic prophylaxis is not necessary for clean wounds.
Department of Emergency Medicine, Catholic Medical Center of Brooklyn, Jamaica, New York.
R B
RB
Birrer
T
T
Robinson
P
P
Papachristos
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004630:Emergencies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000209:etiology* / Q000628:therapy; D009917:Orbital Fractures / Q000150:complications* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013352:Subcutaneous Emphysema / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed