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Minimally Invasive Surgical Decompression of Occipital Nerves

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Published on: September 13, 2024

Visual loss following head and neck surgery.

A J B Crockett¹, A Trinidade, P Kothari

¹Department of ENT, Luton and Dunstable Hospital, Luton, UK.

The Journal of Laryngology and Otology

|October 19, 2011

Summary

Non-arteritic anterior ischemic optic neuropathy (NAION) can occur after head and neck surgery due to blood loss. Early recognition by otolaryngologists is vital for managing this vision-threatening complication.

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Area of Science:

Ophthalmology
Otolaryngology
Neurosurgery

Background:

Non-arteritic anterior ischemic optic neuropathy (NAION) is a recognized complication following ophthalmic and maxillofacial procedures.
Its occurrence after head and neck surgery is less frequently documented.

Observation:

A 60-year-old male patient developed severe visual disturbances 14 days post-total laryngectomy and bilateral neck dissection.
The visual impairment was attributed to acute hypoxemia resulting from significant oral bleeding caused by an internal jugulo-neopharyngeal fistula.

Findings:

Ophthalmological evaluation confirmed the diagnosis of non-arteritic anterior ischemic optic neuropathy (NAION).
The condition was directly linked to the patient's substantial blood loss and subsequent hypoxemia.

Implications:

Non-arteritic anterior ischemic optic neuropathy (NAION) carries a poor prognosis, often leading to permanent visual deficits.
Otolaryngologists must be vigilant for this complication, as prompt diagnosis and intervention are critical to mitigate vision loss in head and neck surgery patients.