Orbital emphysema following nose blowing as a sequel of a snowboard related head injury

Every kind of sport carried the potential risk of injury. Snowboarding is now one of the most popular winter sports. With the growth in the snowboarding population, snowboard related injuries have inevitably increased. More than half the snowboarders injured suffer closed head injuries, but most are mild. ¹ There have been few reports on sequels to mild head injury, ² though there are data on major head injuries requiring tertiary referral. Orbital emphysema is well documented but has not merited much attention, presumably because it is a benign self limiting condition. However, it assumes importance when complications occur such as infection or loss of vision because of pressure effects.

We report a case of orbital emphysema in a young man as a sequel of a mild snowboard related head injury and discuss the efficacy of wearing goggles to prevent this type of injury.

CASE REPORT

An otherwise healthy 19 year old man presented with swelling of his left eyelid. He fell while snowboarding and hit his left forehead on the snowy ground. He was not wearing a helmet or goggles. He denied any impact to the orbit or the nose. This blunt trauma did not result in any clinical problem and he continued snowboarding. Four hours later, he felt a "pop" in the left eye while blowing his nose. Immediately after this he became aware of narrowing of the palpebral fissure. He had no pain and no disturbance in his vision. He visited our outpatient clinic in the following day. Examination revealed no abnormality other than inflation of his left eyelid causing ptosis. Computed tomography with 2 mm slice thickness...