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Orbital Emphysema From Chronic Intranasal Cocaine Use
Gio Manguerra1, Wesley Eilbert1
1Department of Emergency Medicine, University of Illinois, College of Medicine, Chicago, Illinois.
Background:
Chronic intranasal cocaine use can cause destruction of sinonasal osteocartilaginous structures. Communication between the paranasal sinuses and the orbit may result in orbital emphysema.
Case Report:
A 47-year old man with a history of chronic intranasal cocaine use presented to the emergency department with two months of recurrent episodes of right eye proptosis exacerbated by nose blowing. Maxillofacial computed tomography revealed a large amount of right orbital emphysema, with obvious destruction of the lateral border of the right ethmoid sinus. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Orbital emphysema requires specific treatment depending on its level of severity. Damage to the midface sinuses from chronic intranasal cocaine use may result in orbital emphysema.
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