Orbital Emphysema From Chronic Intranasal Cocaine Use.

BACKGROUND

Chronic intranasal cocaine use can cause destruction of sinonasal osteocartilaginous structures. Communication between the paranasal sinuses and the orbit may result in orbital emphysema.

CASE REPORT: A 47-year old man with a history of chronic intranasal cocaine use presented to the emergency department with two months of recurrent episodes of right eye proptosis exacerbated by nose blowing. Maxillofacial computed tomography revealed a large amount of right orbital emphysema, with obvious destruction of the lateral border of the right ethmoid sinus. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Orbital emphysema requires specific treatment depending on its level of severity. Damage to the midface sinuses from chronic intranasal cocaine use may result in orbital emphysema.