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Fabrizio FRANCO 1, Stanislao RIZZO 1, Chiara ADEMBRI 2
1 Eye Clinic, Careggi University Hospital, Florence, Italy; 2 Department of Sense Orgas Anesthesia, Careggi University Hospital, Florence, Italy
We present here the clinical history of a patient with fracture of lamina papyracea of the ethmoid and subcutaneous emphysema by retrobulbar block in vitreoretinal surgery. A 48 years old patient, myopic, pseudophakic, retinitis pigmentosa, underwent vitrectomy 25 G in OS for revision of retinal detachment. It is performed retrobulbar anesthesia (ropivacaine + hyaluronidase). After surgery a maxillofacial surgeon’s assessment and a direct TC scan are performed. The physical examination reveals subcutaneous emphysema, the direct TC scan highlights the presence of intraorbital and subcutaneous air bubble and the breaking of lamina papyracea of the ethmoid. The fracture of lamina papyracea of the ethmoid is a possible complication of retrobulbar anesthesia and can lead to subcutaneous emphysema. The clinical picture resolves itself and doesn’t need a surgical treatment.