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Tension pneumo‐orbitus and pneumocephalus induced by a nasal oxygen cannula: Report on two paediatric cases
Author(s) -
O’Brien Bj,
Rosenfeld Jv,
Elder Je
Publication year - 2000
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1046/j.1440-1754.2000.00550.x
Subject(s) - medicine , pneumocephalus , decompression , exophthalmos , surgery , sinusitis , cannula , sinus (botany) , complication , orbit (dynamics) , orbital cellulitis , diplopia , anesthesia , radiology , cellulitis , botany , engineering , biology , genus , aerospace engineering
: The present paper highlights the potential dangers of misplaced nasopharyngeal oxygen cannulae causing secondary pneumo‐orbitus and pneumocephalus in two paediatric patients. While this complication is uncommon, early recognition allows prompt and appropriate intervention, with cessation of nasal oxygen, cannula removal, early investigation with computed tomography (CT) head/orbit scan and orbital or cranial decompression, if required. Early CT imaging identifies medial orbital or paranasal sinus fractures, the presence of sinusitis, associated intracranial air and assessment of the degree of orbital or intracranial tension. Antibiotics are not usually required for this type of clean injury unless pre‐existing sinusitis is identified. In both cases, direct orbital decompression was performed with excellent results after identification of marked unilateral tense exophthalmos, delayed pupillary reactions to light and ophthalmopegia.