Bartotraumatic Blowout Fracture After Sneezing: Cone Beam CT demonstration

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Rarely a blowout orbital fracture is related to sneezing in patients with no history oftrauma or sinus surgery. A case of barotraumatic, pure and isolated blowout fracture ofthe right orbit after sneezing diagnosed by CBCT is reported. A forty-year-old mancomplained sudden right diplopia after vigorous sneezing. On MRI a reduced size andan altered shape of the right maxillary sinus, a slightly increased vertical diameter ofthe right orbit, a round shape of the inferior rectus muscle on coronal sections, and aright maxillary haemosinus were observed. A strong peripheral enhancement of themaxillary sinus wall was evident. One week after the patient was submitted to amaxillofacial CBCT (90 kVp, 13 mA, 20 s rotation time, FOV 13 x 14.5 cm, 0.25 x 0.25mm pixel size) at our Institution. A blowout fracture of the orbital floor and lateral orbitalwall with an intact orbital rim and a maxillary sinus effusion were detected. Thehydraulic theory can explain how hydraulic forces generated during nose blowing orsneezing causes a blowout fracture of the orbital floor. Incarceration of extraocularmuscles within an orbital fracture is the most commonly reported cause for diplopia.However it was postulated that traumatic haemorrhage causes swelling of the posteriorinferior orbital fat, producing strain on inferior rectus and inferior oblique muscles withconsequent diplopia. Radiologists and more generally doctors should be aware thatamong the causes of sudden diplopia can be also included a barotraumatic blowoutfracture of the orbit after sneezing.
Lingua originaleEnglish
Numero di pagine6
Stato di pubblicazionePublished - 2013


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