An 8-year-old female patient was referred to the guardian of the bleeding with diagnosis of orbital spasmitis for hospitalization, intravenous treatment and urgent assessment by endoscopy.
Physical examination revealed erythema and upper eyelid edema of 12 hours duration, which made eye opening difficult, vertical gaze, pruritus and right eyelid crackling limited.
She was in good general condition and afflicted.
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A thorough examination revealed minimal trauma to the face 20 h prior to consultation and a sneeze episode immediately before the onset of the clinical picture.
With suspicion of subcutaneous emphysema secondary to a sinus fracture, the patient requested: X-ray of the paranasal sinuses (velation of the right maxillary sinus), CT of the orbit in axial and coronal sections (zone of right upper globe displacement).
Heavy lamp, normal visual acuity, and normal eye fundus
A papyraceous lamina fracture of the ethmoid was diagnosed.
Secondary subcutaneous emphysema completely reabsorbs spontaneously at 4 days of evolution.
He received prophylactic treatment with amoxicillin/clavulanic acid and symptomatic treatment.
