Brasileiro Bernardo Ferreira, Cortez André Luís Vieira, Asprino Luciana, Passeri Luis Augusto, De Moraes Márcio, Mazzonetto Renato, Moreira Roger William Fernandes
Division of Oral and Maxillofacial Surgery, Campinas State University, Piracicaba Dental School, Piracicaba, São Paulo, Brazil.
J Oral Maxillofac Surg. 2005 Aug;63(8):1080-7. doi: 10.1016/j.joms.2005.04.007.
The purpose of this report was to review and analyze the epidemiologic features of traumatic subcutaneous emphysema (TSE) originating from frontal, nasoethmoidal, and maxillary facial injuries with sinusal involvement in the emergency room setting.
All patients with a fracture involving the paranasal sinuses were evaluated with regard to TSE occurrence. Data analysis extended to gender, age, etiology, fracture sites, TSE location, sinus involvement, treatment, and complications from April 1999 to December 2003. Evaluation methods included computed tomography scan and clinical evaluation.
A total of 390 patients sustaining 458 paranasal sinus fractures were included. TSE was observed in 29 patients (7.43%) patients (male-female ratio of 3.83:1, with a mean age of 36.71 +/- 15.71 years). The main etiologies were vehicle accidents and assaults. Isolated maxillary sinuses fractures were found in 17 cases (58.62%). Ethmoidal and maxillary fractures were associated with 9 cases (31.03%), and 1 (3.45%) case had maxillary and frontal fractures together. Ethmoidal, maxillary, and frontal fractures were found concomitantly in 2 (6.90%) cases. Periorbital emphysema was the most prevalent site of presentation, and edema (86.21%) and bone deformities (79.31%) were the most frequent findings associated with TSE. Conservative treatment was the prevalent treatment choice (55.17%), and 1 complication because of persistent pain was noted.
The results suggest that TSE of the face associated with paranasal sinus fractures maintained the clinical features of its fractures of origin. The ethmoidal sinuses were considered as the most prevalent etiologic site, and the periorbital region was responsible for addressing the higher incidence of SE following paranasal sinus fractures.
本报告旨在回顾和分析急诊室中因额部、鼻筛部及上颌面部损伤累及鼻窦而导致的创伤性皮下气肿（TSE）的流行病学特征。
对所有累及鼻窦骨折的患者进行TSE发生情况评估。数据分析涵盖1999年4月至2003年12月期间的性别、年龄、病因、骨折部位、TSE位置、鼻窦受累情况、治疗及并发症。评估方法包括计算机断层扫描和临床评估。
共纳入390例发生458处鼻窦骨折的患者。29例（7.43%）患者观察到TSE（男女比例为3.83:1，平均年龄36.71±15.71岁）。主要病因是车祸和袭击。孤立的上颌窦骨折17例（58.62%）。筛窦和上颌窦骨折9例（31.03%），上颌窦和额窦骨折1例（3.45%）。筛窦、上颌窦和额窦同时骨折2例（6.90%）。眶周气肿是最常见的表现部位，水肿（86.21%）和骨畸形（79.31%）是与TSE相关的最常见发现。保守治疗是最常用的治疗选择（55.17%），记录到1例因持续疼痛出现的并发症。
结果表明，与鼻窦骨折相关的面部TSE保持了其原发骨折的临床特征。筛窦被认为是最常见的病因部位，眶周区域导致鼻窦骨折后皮下气肿发生率较高。
