咳き込みにより生じた眼窩気腫の1例

A Case of Orbital Emphysema Caused by Coughing

はじめに

　眼窩気腫は日常診療では顔面外傷，特に眼窩周囲骨折症例に見られる。外傷後に鼻かみやくしゃみなど鼻腔内圧を上昇させることで，空気が骨折部を介して眼窩内に侵入し，眼窩気腫は生じる。今回，外傷が契機でない眼窩気腫というまれな症例を経験したため文献的考察を加えて報告する。

　We treated a 69-year-old man with orbital emphysema triggered by coughing. CT showed right orbital emphysema and an orbital medial lateral wall fracture. Four days after the onset of emphysema, the patientʼs eyelid swelling had decreased and there was no diplopia. The patientʼs CPAP was stopped for conservative treatment but was resumed at 1 week post-onset at the patientʼs discretion due to elevated blood pressure and strong drowsiness. There have been reports of orbital emphysema triggered by sneezing, but our literature search identified no reports of emphysema triggered by coughing.