title: Morphological characteristics and clinical manifestations of orbital emphysema caused by isolated medial orbital wall fractures.
abstract: OBJECTIVE
  To investigate the morphological characteristics and clinical manifestations of orbital emphysema in patients with isolated medial orbital wall fractures.
  
  
  METHODS
  This was a retrospective observational case series of 348 orbits of 348 patients with isolated medial orbital wall fractures. Medical charts were reviewed, and computed tomographic (CT) images were examined to determine the morphological characteristics of orbital emphysema.
  
  
  RESULTS
  Orbital emphysema was detected in 70 orbits (20.1%). Large and communited type fracture was related with the presence of orbital emphysema (P<0.05). Orbital air pockets were detected in medial or superior extraconal orbital segment in all cases with orbital emphysema. Swollen eyelid with crepitus (90.0%) and supraduction limitation (31.4%) were developed with orbital emphysema. All cases with supraduction limitation accompanied with superior extraconal orbital emphysema and superior rectus muscle deviation, and these eyes were fully recovered with conservative management without surgery.
  
  
  CONCLUSIONS
  Orbital emphysema can be a cause of ocular motility restriction following orbital wall fracture. If supraduction limitation is noted with isolated medial wall fracture and superior orbital emphysema with superior rectus muscle deviation is detected by CT scan, conservative management can be a good choice for spontaneous recovery delaying the surgery.
authors.affiliation: Yeonsu Ever Bright Eye Clinic, Incheon, Korea.
authors.forename: H
authors.initials: H
authors.lastname: Moon
authors.affiliation: Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea.
authors.forename: J M
authors.initials: JM
authors.lastname: Wi
authors.affiliation: Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea.
authors.forename: M
authors.initials: M
authors.lastname: Chi
mesh_terms: D000293:Adolescent; D000328:Adult; D004646:Emphysema / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D005141:Eyelid Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000175:diagnosis*; D009915:Orbit / Q000000981:diagnostic imaging / Q000473:pathology*; D009917:Orbital Fractures / Q000150:complications* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed