Halbach Caroline S, Harrison Andrew R, Broadbent Talmage J, Mokhtarzadeh Ali
Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA.
Department of Otolaryngology, University of Minnesota, Minneapolis, MN, USA.
Am J Ophthalmol Case Rep. 2018 Dec 19;13:99-101. doi: 10.1016/j.ajoc.2018.12.013. eCollection 2019 Mar.
If not recognized and treated promptly, nontraumatic orbital subperiosteal hemorrhage (NTSOH) can have serious sequelae including compressive optic neuropathy and permanent vision loss. The following case establishes erotic asphyxiation as a cause of NTSOH.
A 29 year-old patient presented with diplopia and periorbital edema and ecchymosis. Complete ophthalmologic exam showed no optic neuropathy. Computed tomography of the orbits revealed a subperiosteal fluid collection in the right orbit. The patient had no risk factors for NTSOH, but after detailed questioning she admitted to participating in erotic asphyxiation prior to the onset of her symptoms. She was observed and subsequently lost to follow up.
To the authors' knowledge, erotic asphyxiation as a cause of orbital subperiosteal hematoma has not been previously reported. Lack of knowledge about erotic asphyxiation amongst healthcare providers may contribute to hesitance to directly question patients about the practice. Clinicians should be aware of erotic asphyxiation as a potential cause of orbital subperiosteal hemorrhage.
如果非创伤性眶骨膜下出血（NTSOH）未得到及时识别和治疗，可能会产生严重的后遗症，包括压迫性视神经病变和永久性视力丧失。以下病例证实性窒息是NTSOH的一个病因。
一名29岁患者出现复视、眶周水肿和瘀斑。完整的眼科检查未发现视神经病变。眼眶计算机断层扫描显示右眼眶有骨膜下液体积聚。该患者没有NTSOH的危险因素，但在详细询问后，她承认在症状出现前参与了性窒息。对她进行了观察，随后失去了随访。
据作者所知，性窒息作为眶骨膜下血肿的病因此前尚未见报道。医疗保健人员对性窒息缺乏了解可能导致不愿直接询问患者有关这种行为的情况。临床医生应意识到性窒息是眶骨膜下出血的一个潜在病因。
