Orbital emphysema: how common, how significant?
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.