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Posttraumatic orbital emphysema: a numerical model.

Andrzej Skorek¹, Paweł Kłosowski², Lukasz Plichta¹

¹Otolaryngology Department, Medical University of Gdansk, Smoluchowskiego Street 17, 80-214 Gdańsk, Poland.

Journal of Ophthalmology

|October 14, 2014

Summary

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Orbital emphysema, often seen with orbital fractures, may be caused by a retrograde shock wave. This study used a finite element model to simulate orbital wall impact, revealing a novel mechanism for this condition.

Area of Science:

Biomechanics
Ophthalmology
Medical Imaging

Background:

Orbital emphysema frequently accompanies orbital fractures.
The exact pathomechanism of orbital emphysema remains unclear.
Elevated upper airway pressure from sneezing or coughing is not always the cause.

Purpose of the Study:

To investigate the pathomechanism of orbital emphysema.
To simulate orbital wall deformation using a finite element model.
To identify the cause of orbital emphysema following blunt trauma.

Main Methods:

A computer numeric model of the orbit was created, incorporating thickness and resilience modulus.
A 14400 N force was applied to the inferior orbital rim in the simulation.
Deformations were observed from 1x10^-3 to 1x10^-2 seconds post-impact.

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Main Results:

Simulations showed initial inferior orbital wall dislocation towards the maxillary sinus.
A subsequent retrograde wave of dislocation towards the orbit was observed.
The overall dislocation amplitude reached approximately 6 mm.

Conclusions:

The study identified a retrograde shock wave as a potential cause of orbital emphysema.
This shock wave is generated by impact to the inferior orbital wall.
Findings challenge traditional assumptions about the etiology of orbital emphysema.