[Temporary amaurosis in endonasal microsurgery of the ethmoid and lacrimal sac in local anaesthesia (author's transl)].
After injection of 1-2 cc. Scandicain and Suprarenin into the ethmoidalis vessels a female patient developed 1972 protrusio bulbi combined with amaurosis. After endonasal lacrimal sac operation with decompression of the orbita the protrusio bulbi disappeared without change of the amaurosis. Under the operating microscope no haematoma was found neither in the ethmoid nor in the orbita. Finally after 35-40 min. under an injection for blockage of the ganglion stellatum, the patient cried: "I can see light". Under further treatment, as known for acute hearing loss, the patient recovered a normal vision. In 1979 we have operated on 96 lacrimal sacs and all together 225 endonasal microsurgical ethmoid resections. After performing more than 8000 ethmoid operative procedures in the years before, a similar complication was observed in 1936 only. No persistent amaurosis was noticed. As amaurosis is extremely rare in our statistics on endonasal microsurgical ethmoid resections under reduction of blood pressure, there is no reason why the patient should be informed preoperatively about this rare complication.
D000772:Anesthesia, Local; D001766:Blindness / Q000139:chemically induced / Q000209:etiology*; D003608:Dacryocystorhinostomy; D005004:Ethmoid Bone / Q000601:surgery; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007431:Intraoperative Complications / Q000209:etiology*; D007765:Lacrimal Apparatus / Q000601:surgery; D008875:Middle Aged; D009407:Nerve Block; D013233:Stellate Ganglion / Q000187:drug effects
Temporäre Amaurose bei mikrochirurgischer endonasaler Ethmoid- und Saccus-lacrimalis-Operation in Lokalanästhesie.