Sinus Barotrauma: Surgical Emphysema

This disorder has been seen on a number of occasions and was described previously5. The tracking of air expanding in the sinuses and erupting into the surrounding tissues can manifest as orbital surgical emphysema (usually from the ethmoidal sinus though a fracture of the egg-shell–thin lamina papyracea; see Plate 2). In other instances, the air has passed from other sinuses, and the disorder can first occur as a localized manifestation in the facial tissues.