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Blindness after bilateral neck dissection: case report and review.
G A Pazos1, D W Leonard, J Blice
1Naval Air Station Cecil Field, Jacksonville, FL, USA.
American Journal of Otolaryngology
|October 8, 1999
Summary
Blindness after bilateral radical neck dissection is often caused by permanent posterior ischemic optic neuropathy (PION). Preventive measures are crucial to avoid this severe complication in head and neck cancer surgery.
Area of Science:
- Ophthalmology
- Head and Neck Surgery
- Oncology
Background:
- Bilateral radical neck dissection is a complex surgical procedure for advanced head and neck cancers.
- Postoperative visual impairment, including blindness, is a rare but devastating complication.
- Understanding the causes is critical for prevention and patient safety.
Observation:
- This literature review and case report identified 11 previous cases of blindness post-bilateral radical neck dissection.
- The authors present a unique case of blindness occurring 9 years after initial dissections.
- Posterior ischemic optic neuropathy (PION) was the most common cause of permanent vision loss.
Findings:
- Posterior ischemic optic neuropathy (PION) was identified as the primary cause of permanent blindness in the reviewed cases.
- Contributing factors in the presented case included anemia, hypotension, and impaired venous collateral circulation.
- The 9-year interval between dissections in the case report highlights potential long-term risks.
Implications:
- Early recognition and management of contributing factors like anemia and hypotension are vital.
- Strategies to maintain adequate optic nerve perfusion and venous return should be considered.
- Further research into preventative measures for visual complications after neck dissection is warranted.