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Peri-orbital surgical emphysema following endoscopic dacryocystorhinostomy

Published online by Cambridge University Press:  21 September 2020

J C Bladen
Affiliation:
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
W F Siah
Affiliation:
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
P Tan
Affiliation:
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
A S Litwin
Affiliation:
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
S Ali
Affiliation:
Department of Anaesthesia, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
R Malhotra*
Affiliation:
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
*
Author for correspondence: Mr Raman Malhotra, Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East GrinsteadRH19 3DZ, UK Fax +44 (0)1342 414106 E-mail: raman@ramanmalhotra.com

Abstract

Background

Peri-orbital surgical emphysema is a rare complication that can occur after lacrimal surgery. It has only been described in isolated cases, following external dacryocystorhinostomy (n = 2) and Lester Jones tube insertion (n = 1).

Method

A retrospective, non-comparative case series was conducted of patients who developed surgical emphysema following endoscopic dacryocystorhinostomy.

Results

A total of 356 endoscopic dacryocystorhinostomy cases (primary, n = 316; revision, n = 40) were performed over a six-year period. Seven cases of post-operative surgical emphysema were identified, all of which were preceded by uncontrolled sneezing, nose-blowing or coughing within the first week of surgery. The occurrence of surgical emphysema post-endoscopic dacryocystorhinostomy in our centre was 7 in 356, or 2 per cent, over six years.

Conclusion

This is the first study to report the occurrence of surgical emphysema post-endoscopic dacryocystorhinostomy. Clinicians may wish to suggest patients stifle the aforementioned triggers within the first week to reduce the potential for surgical emphysema.

Type
Main Articles
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Mr R Malhotra takes responsibility for the integrity of the content of the paper

References

Ghosheh, FR, Kathuria, SS. Massive subcutaneous emphysema mimicking necrotizing fasciitis after dacryocystorhinostomy. Ophthalmic Plast Reconstr Surg 2005;21:389–91CrossRefGoogle ScholarPubMed
Rodriguez, MJ, Dave, SP, Astor, FC. Periorbital emphysema as a complication of functional endoscopic sinus surgery. Ear Nose Throat J 2009;88:888–9CrossRefGoogle ScholarPubMed
Tzifa, KT, Skinner, DW. Peri-orbital surgical emphysema following functional endoscopic sinus surgery, during extubation. J Laryngol Otol 2001;115:916–17CrossRefGoogle ScholarPubMed
Parkar, A, Medhurst, C, Irbash, M, Philpott, C. Periorbital oedema and surgical emphysema, an unusual complication of a dental procedure: a case report. Cases J 2009;2:8108CrossRefGoogle ScholarPubMed
Colemont, LJ, Pelckmans, PA, Moorkens, GH, Van Maercke, YM. Unilateral periorbital emphysema: an unusual complication of endoscopic papillotomy. Gastrointest Endosc 1988;34:473–5CrossRefGoogle ScholarPubMed
Zimmer-Galler, IE, Bartley, GB. Orbital emphysema: case reports and review of the literature. Mayo Clin Proc 1994;69:115–21CrossRefGoogle ScholarPubMed
Abdesslem, K, Sondes, B, Wael, E, Hajer, T, Morched, D, Fathi, K et al. A case of post-traumatic severe orbital emphysema: case report and literature review [in French]. J Fr Ophtalmol 2014;37:e165–7CrossRefGoogle Scholar
Malhotra, R, Norris, JH, Sagili, S, Al-Abbadi, Z, Avisar, I. The learning curve in endoscopic dacryocystorhinostomy: outcomes in surgery performed by trainee oculoplastic surgeons. Orbit 2015;34:314–19CrossRefGoogle Scholar
Patel, V, Ross, JJ, Malhotra, R. Early experience using a new modified bone nibbler for superior osteotomy during endonasal dacryocystorhinostomy. Ophthalmic Plast Reconstr Surg 2011;27:1520CrossRefGoogle ScholarPubMed
Lima, V, Burt, B, Leibovitch, I, Prabhakaran, V, Goldberg, RA, Selva, D. Orbital compartment syndrome: the ophthalmic surgical emergency. Surv Ophthalmol 2009;54:441–9CrossRefGoogle ScholarPubMed
Sultan, H, Malik, A, Li, HK, Chevez-Barrios, P, Lee, AG. Necrotizing fasciitis of the periorbital region complicated by combined central retinal artery occlusion, central retinal vein occlusion, and posterior ciliary occlusion. Ophthalmic Plast Reconstr Surg 2017;33:e75–6CrossRefGoogle ScholarPubMed