title: Orbital apex syndrome after ethmoidal artery ligation for recurrent epistaxis.
abstract: A 34-year-old man with severe, recurrent epistaxis underwent external anterior and posterior ethmoidal artery ligation on the right side. Visual loss from optic neuropathy and complete ophthalmoplegia developed after surgery. Computed tomography revealed surgical clips within the right orbital apex. Emergent removal of the surgical clips and medial wall decompression were performed. Four weeks later, his visual acuity and extraocular motility were unchanged, and diffuse pallor of the right optic disc was observed. Orbital apex syndrome can be a complication of ethmoidal artery ligation. Severe visual loss and ophthalmoplegia may persist despite prompt recognition and treatment.
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Yeh
authors.forename: Michael T
authors.initials: MT
authors.lastname: Yen
authors.forename: Rod
authors.initials: R
authors.lastname: Foroozan
mesh_terms: D000328:Adult; D001158:Arteries; D001766:Blindness / Q000000981:diagnostic imaging / Q000209:etiology*; D004844:Epistaxis / Q000601:surgery*; D005005:Ethmoid Sinus / Q000098:blood supply* / Q000601:surgery; D006801:Humans; D008026:Ligation / Q000009:adverse effects; D008297:Male; D009886:Ophthalmoplegia / Q000000981:diagnostic imaging / Q000209:etiology*; D009901:Optic Nerve Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects*; D012008:Recurrence; D013577:Syndrome; D014057:Tomography, X-Ray Computed