Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-19T13:58:18.280Z Has data issue: false hasContentIssue false

Bilateral blindness following anterior nasal packing in a case of nasopharyngeal angiofibroma

Published online by Cambridge University Press:  08 November 2016

A K Sahoo
Affiliation:
ENT Department, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
C Preetam*
Affiliation:
ENT Department, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
R Kumar
Affiliation:
ENT Department, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
D K Samal
Affiliation:
ENT Department, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
*
Address for correspondence: Dr C Preetam, ENT Department, All India Institute of Medical Science, Bhubaneswar, Odisha, India E-mail: drcpreetam@aiimsbhubaneswar.edu.in

Abstract

Background:

Epistaxis is the most common ENT emergency encountered in the Emergency Department. Most cases can be managed by simple anterior nasal packing. This is usually a safe and very effective option in an emergency situation, requiring minimal expertise and infrastructure. This paper describes a rare instance of a serious complication following anterior nasal packing in a case of nasopharyngeal angiofibroma.

Case report:

A 27-year-old man diagnosed with nasopharyngeal angiofibroma presented to the Emergency Department with bilateral epistaxis. The patient was stabilised and anterior nasal packing was performed, which controlled the bleeding. Three hours later, the patient developed complete blindness in both eyes. Aggressive medical management was initiated immediately, but failed to restore the patient's vision.

Conclusion:

Anterior nasal packing is a simple and minimally invasive procedure practised regularly in an Emergency Department setting. However, it can occasionally lead to serious complications such as blindness. Thus, obtaining informed consent is essential to avoid medico-legal consequences in high-risk cases.

Type
Clinical Record
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Koudounarakis, E, Chatzakis, N, Papadakis, I, Panagiotaki, I, Velegrakis, G. Nasal packing aspiration in a patient with Alzheimer's disease: a rare complication. Int J Gen Med 2012;5:643–5CrossRefGoogle Scholar
2 Rodney, JS. Epistaxis: a clinical experience. N Engl J Med 2009;360:784–9Google Scholar
3 Edkins, O, Nyamarebvu, CT, Lubbe, D. Cerebrospinal fluid rhinorrhoea after nasal packing for epistaxis: case report. J Laryngol Otol 2012;126:421–3CrossRefGoogle ScholarPubMed
4 Montgomery, PQ, Khan, JI, Feakins, R, Nield, DV. Paraffinoma revisited: a post-operative condition following rhinoplasty nasal packing. J Laryngol Otol 1996;110:785–6CrossRefGoogle ScholarPubMed
5 Giammanco, P, Binns, PM. Temporary blindness and ophthalmoplegia from nasal packing. J Laryngol Otol. 1970;84:631–5CrossRefGoogle ScholarPubMed
6 Aga, A. Juvenile nasopharyngeal angiofibroma presenting as Foster Kennedy Syndrome. Ethiop Med J 2001;39:251–60Google ScholarPubMed
7 Hayreh, SS. Management of ischemic optic neuropathies. Indian J Ophthalmol 2011;59:123–36CrossRefGoogle ScholarPubMed