Ocular blood flow alterations during inferior turbinate radiofrequency reduction under local anesthesia.
BACKGROUND
Ocular blood flow alterations and blindness are uncommon and less-known adverse effects of nasal local anesthetic infiltrations. Our aim was to investigate ocular blood flow alterations during radiofrequency (RF) tissue reduction of inferior turbinates with the patient under local anesthesia by using a noninvasive method with optical coherence tomography.


METHODS
A total of 120 patients with inferior turbinate hypertrophy were prospectively randomized into two groups. In group 1, a total of 61 patients underwent RF tissue reduction while under local anesthesia with epinephrine. In group 2, a total of 59 patients underwent RF tissue reduction of inferior turbinates while under local anesthesia without epinephrine. Optical coherence tomography measurements were performed before surgery and at 5, 15, 30, 45, and 60 minutes after local anesthetic infiltration.


RESULTS
Choroid thickness measurements decreased gradually after local anesthetic infiltration until 30 minutes and increased to the same plane with the baseline at 60 minutes in group 1 (p < 0.05). In group 2, the choroid thickness measurement was significantly decreased after local anesthetic infiltration at 15 and 45 minutes (p < 0.05). When the choroid thickness measurements were compared between the groups, in group 1 blood flow was significantly lower than in group 2 at 30 minutes (p < 0.05).


CONCLUSIONS
We observed a statistically significant reduction in choroid circulation after local anesthetic with epinephrine infiltration into inferior turbinates. Otolaryngologists should be careful after local anesthetic infiltration, and monitor the vision. Further studies with larger series would be needed to discuss safety of local anesthetics.
Otolaryngology Clinic, Faculty of Medicine, Adıyaman University, Adıyaman, Turkey.
Sedat
S
Doğan
Ali
A
Şimşek
Cem
C
Bayraktar
Haşmet
H
Yazıcı
Yasin
Y
Sarıkaya
Mehmet
M
Karataş
Ayşe Sevgi
AS
Karadağ
Musa
M
Çapkın
D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D000772:Anesthesia, Local; D002829:Choroid / Q000033:anatomy & histology*; D004837:Epinephrine / Q000627:therapeutic use*; D005123:Eye / Q000473:pathology*; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D015508:Nasal Obstruction / Q000601:surgery*; D009799:Ocular Physiological Phenomena; D011446:Prospective Studies; D061208:Pulsed Radiofrequency Treatment; D012039:Regional Blood Flow; D041623:Tomography, Optical Coherence / Q000379:methods; D016896:Treatment Outcome; D014420:Turbinates / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
D000700:Analgesics; D004837:Epinephrine