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Neuro-ophthalmic complication after maxillary surgery.

A De Zutter1, H Deconinck, G Rodesch

  • 1Dept. of Ophthalmology, Children's Hospital Brussels H.U.D.E.R.F.-VUB.

Bulletin De La Societe Belge D'Ophtalmologie
|June 4, 1999
PubMed
Summary

An unusual case of ophthalmoplegia, or eye movement paralysis, occurred after maxillofacial surgery in a young girl. The cause was a hemorrhage behind the cavernous sinus, not typical orbital injuries.

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Area of Science:

  • Ophthalmology
  • Maxillofacial Surgery
  • Neurology

Background:

  • Cleft lip and palate repair often involves complex surgical procedures.
  • Maxillary advancement by distraction osteogenesis is a common technique for correcting midface hypoplasia.
  • Post-surgical complications, though rare, require careful evaluation.

Observation:

  • A 13-year-old girl developed diplopia (double vision) after undergoing maxillary advancement.
  • The patient had a history of unilateral left cleft lip and palate.
  • Ophthalmoplegia, or paralysis of eye muscles, was the primary symptom.

Findings:

  • Ophthalmoplegia was attributed to a hemorrhage posterior to the cavernous sinus.
  • The diplopia was not caused by orbital lesions, a more frequent complication.

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  • Imaging studies confirmed the retrocavernous sinus hemorrhage.

    • Implications:

    • This case highlights a rare but serious complication following maxillofacial surgery.
    • It underscores the importance of considering retrocavernous sinus hemorrhage in ophthalmoplegia post-surgery.
    • Prompt diagnosis and management are crucial for favorable outcomes in such cases.