Anterior ischemic optic neuropathy following neck dissection.
BACKGROUND
Ischemic optic neuropathy (ION) is a rare but devastating complication of surgery. It has traditionally been associated with intraoperative hypotension in patients with underlying arteriosclerosis.


METHODS
We present a case of ION following bilateral neck dissections in which there was minimal intraoperative hypotension and preservation of both internal jugular veins. The potential etiology of this disease is discussed along with a review of the literature.


RESULTS
Five cases of ION following neck dissection have been documented. This complication is associated with the combination of intraoperative hypotension and anemia in the setting of prolonged bilateral neck dissection. Treatment is supportive, and final visual prognosis is variable.


CONCLUSIONS
Ischemic optic neuropathy following neck dissection is best avoided by intraoperative blood pressure and anemia management. When it does occur, supportive therapy must be given. Final visual outcome is variable.
Strome
S E
SE
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor 48109, USA.
Hill
J S
JS
Burnstine
M A
MA
Beck
J
J
Chepeha
D B
DB
Esclamado
R M
RM
D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008339:Mandibular Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects*; D018917:Optic Neuropathy, Ischemic / Q000209:etiology* / Q000503:physiopathology; D012075:Remission, Spontaneous; D014792:Visual Acuity