title: Postoperative anisocoria in a patient undergoing endoscopic sinus surgery.
abstract: OBJECTIVE
  Anisocoria after sinus surgery can be related to serious complications such as intraorbital hematoma or increased intracranial pressure secondary to an expanding hematoma.
  
  
  METHODS
  A 51-year-old man underwent endoscopic surgery of sinuses, and developed anisocoria; likely a result of the local spread of cocaine used to provide local anesthesia and vasoconstriction. The localized effect of this anesthetic agent produced a typical picture of nasociliary ganglion block that subsided in a few hours. In the results, the nasociliary nerve block was noticed on recovery from anesthesia with no other neurologic deficit. Ophthalmologic examination demonstrated a short-lasting anisocoria with loss of accommodation and sensory block over the tip of the nose.
  
  
  CONCLUSIONS
  The central spread of the local anesthetics should be considered as a differential diagnosis of unexplained anisocoria, especially when it is associated with loss of corneal reflex.
authors.affiliation: Department of Anesthesiology, State University of New York at Buffalo, USA.
authors.forename: D
authors.initials: D
authors.lastname: Stewart
authors.forename: G T
authors.initials: GT
authors.lastname: Simpson
authors.forename: N D
authors.initials: ND
authors.lastname: Nader
mesh_terms: D000779:Anesthetics, Local / Q000009:adverse effects*; D015875:Anisocoria / Q000139:chemically induced / Q000175:diagnosis*; D003042:Cocaine / Q000009:adverse effects*; D004724:Endoscopy; D005005:Ethmoid Sinus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced / Q000175:diagnosis*; D012852:Sinusitis / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D000779:Anesthetics, Local; D003042:Cocaine