Tarım Bilge, Kılıç Meltem
Department of Ophthalmology, Beypazarı State Hospital, Ankara, Türkiye.
Department of Ophthalmology, Ankara Bilkent City Hospital, Ankara, Türkiye.
Indian J Plast Surg. 2024 Nov 26;58(2):136-138. doi: 10.1055/s-0044-1795150. eCollection 2025 Apr.
A 41-year-old man presented with sudden-onset swelling, redness, and pain in the right eye, 4 days after bilateral upper and lower eyelid blepharoplasty. The symptoms were preceded by a forceful nose-blowing episode. Upon examination, periorbital edema and subcutaneous crepitus were observed, along with limitations in upward gaze. Computed tomography revealed bilateral premaxillary and extraconal air accumulation. Since there was no optic nerve ischemia or orbital compartment syndrome, the patient was closely monitored. Spontaneous regression of the emphysema was observed during follow-ups. Orbital emphysema, although commonly associated with trauma, can also arise from compelling movements such as severe nose-blowing, as demonstrated in this unique case postblepharoplasty. The structural changes during surgery may contribute to weakened support, predisposing patients to emphysema following sudden pressure changes. Clinicians should be vigilant for periorbital edema and subcutaneous crepitus after facial surgeries, emphasizing the importance of timely imaging for diagnosis. Awareness campaigns advising against forceful actions like sneezing, coughing, and nose-blowing during the initial postoperative period are crucial to prevent potential complications.
一名41岁男性在双侧上下眼睑整形术后4天，出现右眼突发肿胀、发红和疼痛。症状出现前有一次用力擤鼻。检查时，发现眶周水肿和皮下捻发音，伴有向上注视受限。计算机断层扫描显示双侧上颌前部和锥体外空气积聚。由于没有视神经缺血或眼眶间隔综合征，对患者进行了密切监测。随访期间观察到肺气肿自发消退。眼眶肺气肿虽然通常与外伤有关，但也可由剧烈擤鼻等强迫性动作引起，如此例眼睑整形术后的独特病例所示。手术过程中的结构变化可能导致支撑减弱，使患者在突然压力变化后易患肺气肿。临床医生应警惕面部手术后的眶周水肿和皮下捻发音，强调及时成像诊断的重要性。开展宣传活动，建议术后初期避免打喷嚏、咳嗽和擤鼻等用力动作，对于预防潜在并发症至关重要。
