Ischemic optic neuropathy after endoscopic sinus surgery: a case report.
For the past 2 decades, endoscopic sinus surgery (ESS) has proven effective for treating paranasal sinus disease. Orbital complications of varying degrees, from mild orbital hematoma to catastrophic blindness, have been widely reported. However, defects of the visual field resulting from post-ESS ischemic optic neuropathy (ION) has not to our knowledge been reported in the literature. We were presented with a 51-year-old male patient suffering from loss of sight following an otherwise uneventful ESS. ION is a rare condition, characterized by acute or subacute postoperative loss of sight. The major risks for developing ION include intraoperative anemia, hypotension and systemic illnesses such as hypertension, diabetes or renal failure. Otorhinolaryngologists should be aware that this condition may occur following an uncomplicated ESS procedure, and patients should be given prompt opthalmological consultation when loss of sight is diagnosed postoperatively. Early aggressive and rapid correction of blood pressure and blood transfusions may be helpful in the treatment of patients who develop ION after surgery.
Department of Otolaryngology and Head and Neck Surgery, Tri-Service General Hospital, No. 325 Section 2, Cheng-Kung Road, 114 Taipei, Taiwan ROC.
Jin-Chin
JC
Lee
Ping-I
PI
Chuo
Ming-Wang
MW
Hsiung
D001766:Blindness / Q000209:etiology; D004724:Endoscopy / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D018917:Optic Neuropathy, Ischemic / Q000175:diagnosis / Q000209:etiology*; D010256:Paranasal Sinuses / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D012852:Sinusitis / Q000601:surgery*; D014057:Tomography, X-Ray Computed