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Orbital emphysema: how common, how significant?
R B Birrer1, T Robinson, P Papachristos
1Department of Emergency Medicine, Catholic Medical Center of Brooklyn, Jamaica, New York.
Study Objective:
To describe the natural history of orbital emphysema and its management in the emergency setting.
Design:
Retrospective medical record review.
Setting:
Inner-city integrated hospital system (four divisions) including one Level I trauma center.
Participants:
All cases of orbital floor fracture and orbital emphysema from January 1, 1988, to December 31, 1993.
Results:
The average patient was aged 33 years, and the male-to-female ratio was 7 to 1. Trauma was the underlying etiology in all patients. Seventy-four percent of patients required hospitalization, and 43% developed significant complications. Eighty-three percent were managed with antibiotics. Orbital emphysema was identified on conventional radiographs in 65% of cases.
Conclusion:
Identification of orbital emphysema in the ED should prompt a careful search for associated injury. Consultation should be sought in the presence of orbital or ocular injury. Antibiotic prophylaxis is not necessary for clean wounds.