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Updated: Jul 3, 2026
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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Intraoperative dilated pupil during nasal polypectomy.
Mudit Jindal1, Neil Sharma, Nilesh Parekh
1Department of Otolaryngology, University Hospital Birmingham, Birmingham, UK. mjindal@doctors.org.uk
Summary
Nasal decongestants like phenylephrine can cause dilated pupils during endoscopic sinus surgery. This finding helps ENT surgeons avoid misdiagnosing intraorbital injury.
Area of Science:
- Otolaryngology
- Ophthalmology
- Pharmacology
Background:
- Nasal decongestants are used in endoscopic sinus surgery to reduce bleeding.
- A common preparation contains Lidocaine Hydrochloride and Phenylephrine Hydrochloride.
Observation:
- A case of unilateral dilated pupil occurred during nasal polypectomy.
- Dilated pupils can indicate intraorbital injury during sinus surgery.
Findings:
- The nasal decongestive agent Phenylephrine Hydrochloride can cause mydriasis (pupil dilation).
- This pharmacological effect can mimic signs of orbital injury.
Implications:
- Recognizing drug-induced mydriasis prevents unnecessary patient anxiety and surgical intervention.
- This knowledge is crucial for ENT surgeons performing sinonasal procedures.
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