Uncommon presentation of blowout fracture: predisposing factors and clinical presentation

Blowout fracture of orbital floor is a common presentation in maxillofacial trauma triage, usually blunt trauma with an object slightly larger than orbital rim is the classic mechanism. In this manuscript a new presentation is described where spontaneous peri-orbital edema and pain observed after aggressive nasal blowing. Computerized tomography reveals defect in the orbital floor with herniation of soft tissue to the sinus. Ipsilateral sinus is clear with thin uniform lining; however the enlarged inferior turbinate obstruct sinus osteoum where, nasal blowing creates sinus negative pressure that could explain fracture mechanism.