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Unilateral blindness: a unique complication of choanal atresia surgery

Published online by Cambridge University Press:  10 January 2014

L D'Ascanio  and
E Rebuffini
L D'Ascanio*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Carlo Poma Civil Hospital, Mantova, Italy
E Rebuffini
Affiliation:
Department of Maxillo-Facial Surgery, University of Ferrara, Italy
*
Address for correspondence: Dr Luca D'Ascanio, Department of Otolaryngology – Head and Neck Surgery, Carlo Poma Civil Hospital, Strada Lago Paiolo, 10-46100 Mantova, Italy Fax: +39 (0)854214566 E-mail: l.dascanio@gmail.com
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Abstract

Objective:

To report a unique case of unilateral blindness secondary to transnasal endoscopic surgery and stenting for right choanal atresia.

Case report:

A 24-year-old man was referred with right eye blindness and acute headache, occurring immediately after transnasal endoscopic surgical repair of unilateral right choanal atresia with placement of an endonasal stent. Maxillo-facial computed tomography with three-dimensional reconstruction showed the endonasal stent entering the right nostril, passing through the lamina papyracea into the orbit and running anterior to the optic foramen towards the superior orbital fissure. Despite stent removal and medical treatment (ceftriaxone and dexamethasone), permanent right eye blindness secondary to an irreversible lesion of the optic nerve was diagnosed. At three-month follow up, an uncommon, complete fibrous obliteration of the right nasal fossa was noticed.

Conclusion:

To the best of our knowledge, this is the only published report of unilateral blindness following transnasal endoscopic stenting for right choanal atresia. Causes of this complication, and ways of avoiding it, are discussed.

Keywords

Nasal Surgical ProceduresNasal CavityAdultChoanal AtresiaComplicationsBlindness

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 1 , January 2014 , pp. 101 - 103
Copyright
Copyright © JLO (1984) Limited 2014 

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