Abstract
Orbital emphysema is usually caused by trauma and fracture of an orbital bone, allowing
air to pass from the sinuses into the orbit. Orbital emphysema without any significant
trauma is rare. We present a case of a 67-year-old-woman who complained of left exophthalmos
without any history of trauma, sneezing, or sinus surgery. Computed tomography scanning
showed left orbital emphysema protruding the eyeball forward. The left frontal sinus
was remarkably enlarged associated with a partial defect of the orbital roof, allowing
air entry into the orbit. In addition, the frontal sinus ostium was occluded with
the mucocele that served as a one-way valve between the frontal and the ethmoidal
sinuses. We performed frontal craniotomy and removed the mucocele and the inner table
of frontal bone to communicate the frontal sinus with the nasal cavity. After operation,
her exophthalmos was improved.
Keywords
orbital emphysema - frontal sinus pneumocele - transcranial surgery
