Subcutaneous and Orbital Emphysema With Pneumocephalus Secondary to Compressed-Air Gun Injury to the Face

Compressed-air guns—devices that remove particles such as dust or wood/metal shavings using compressed air—are now widely used in industry. Although rare, the high-speed airflow they generate can cause injuries. A healthy 26-year-old man presented to our emergency department with swelling around his right eye and headache. His history revealed that the injury occurred during routine use of a compressed-air gun while cleaning work clothes. The blast of compressed air to his face resulted in subcutaneous emphysema, orbital emphysema, and pneumocephalus. No obvious entry site for the air could be identified, and no skull, facial, or orbital fractures were present. Compressed-air gun injuries can therefore cause orbital and periorbital emphysema and pneumocephalus, even in the absence of any skull or facial bone fractures detected on routine radiologic examinations or obvious conjunctival tears on ophthalmological examination. The route of air entry into these compartments may be transorbital, transnasal, or transoral, but the precise trajectory remains challenging to determine.