Pneumomediastinum during flight secondary to facial fractures--a case report.

A case of inflight cervical emphysema and pneumomediastinum secondary to a "blowout" fracture of the right lateral orbit and maxillary sinus is described. A 43-yr-old male was struck on the face by another passenger during a flight from Australia to Greece. The cause of the emphysema and its fast progression is discussed with respect to the anatomic relations of the facial and cervical subcutaneous space and the mediastinum. The injured passenger was treated 3 h after arrival in Thessaloniki, Greece. This case demonstrates a potential complication of a "blowout" orbital fracture during flight. The condition should be recognized by emergency department personnel with the patient kept under observation and symptomatic treatment initiated. Prophylactic antibiotics should be considered.