title: Compressed air blast injury with palpebral, orbital, facial, cervical, and mediastinal emphysema through an eyelid laceration: a case report and review of literature.
abstract: BACKGROUND
  To the best of our knowledge, only 14 cases of orbital or periorbital compressed air injuries from air guns or hoses have been reported in the literature.
  
  
  METHODS
  A 30-year-old man was accidentally injured when a compressed air hose nozzle hit his right eye. The right half of his face was markedly swollen and a skin laceration near the right medial canthus was identified. A computed tomography scan showed subcutaneous and intraorbital emphysema around the right eye as well as cervical and mediastinal emphysema. He was prophylactically treated with systemic and topical antibiotics to prevent infection. All emphysemas had completely resolved 2 weeks after the injury.
  
  
  CONCLUSIONS
  A review of all 15 cases (including ours) showed that all patients were male and that 6 of the 15 (40.0%) cases were related to industrial accidents. Although emphysema was restricted to the subconjunctival space in 2 (13.3%) cases, it spread to the orbit in the remaining 13 (86.7%) cases. Cervical and mediastinal emphysemas were found in 3 (20.0%) cases, and intracranial emphysema was confirmed in 6 (40.0%) cases. Prophylactic antibiotics were used in most cases and the prognosis was generally good in all but one patient, who developed optic atrophy and blindness.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan. thiraoka@md.tsukuba.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hiraoka
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ogami
authors.forename: Fumiki
authors.initials: F
authors.lastname: Okamoto
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Oshika
mesh_terms: D000328:Adult; D000388:Air; D019072:Antibiotic Prophylaxis; D001753:Blast Injuries / Q000150:complications*; D015807:Eye Injuries, Penetrating / Q000150:complications*; D005143:Eyelids / Q000293:injuries*; D005145:Face; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology*; D009333:Neck; D009916:Orbital Diseases / Q000209:etiology*; D013352:Subcutaneous Emphysema / Q000209:etiology*