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Periorbital emphysema after a wet chamber dive
Wei-Shih Tseng1,2, Hui-Chieh Lee1, Bor-Hwang Kang1,3,4
1Department of Diving and Hyperbaric Medicine, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
Diving and Hyperbaric Medicine
|September 5, 2017
Summary
Periorbital emphysema (PE) can occur without trauma, even in divers. This case highlights sinus barotrauma as a cause, with conservative treatment leading to full recovery.
Area of Science:
- Otolaryngology
- Diving Medicine
- Emergency Medicine
Background:
- Periorbital emphysema (PE) is often linked to orbital fractures but can arise from non-traumatic causes like infections or forceful exhalations.
- Diving activities, particularly those involving pressure changes, present a unique scenario for barotrauma-induced PE.
Observation:
- A healthy military diver presented with PE after a wet chamber dive.
- The condition was diagnosed as PE secondary to sinus barotrauma.
Findings:
- The diver experienced a complete recovery within 10 days with conservative, non-medicinal management.
- This case, along with five previously reported instances, suggests diving-related PE is rare.
Implications:
- Forceful Valsalva maneuvers, facial trauma, and recent upper respiratory infections may increase the risk of PE in divers.
- Understanding these risk factors can aid in preventing and managing PE in underwater occupational settings.
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