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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

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Meningoencephalitis Following Endoscopic Dacryocystorhinostomy.

Timothy Z Cheong¹, Rodger P Davies

¹The Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.

Ophthalmic Plastic and Reconstructive Surgery

|February 8, 2019

Summary

A rare case of meningoencephalitis (brain and meninges inflammation) occurred after endonasal dacryocystorhinostomy surgery. Early diagnosis and antibiotic treatment led to a full recovery, highlighting the need for vigilance after this common procedure.

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Area of Science:

Otolaryngology
Neurosurgery
Infectious Disease

Background:

Endonasal dacryocystorhinostomy is a common surgical procedure for nasolacrimal duct obstruction.
Complications, though rare, can be severe and require prompt recognition.

Observation:

An 81-year-old male developed severe headache and rigors two days after endonasal DCR.
Imaging revealed an anterior cranial fossa floor defect and adjacent meningoencephalitis.
The patient presented with febrile septic symptoms post-operatively.

Findings:

The study reports the first known case of meningoencephalitis following endonasal DCR.
Cranial fossa floor defect was suspected to be iatrogenically caused during surgery.
Intravenous antibiotic therapy resulted in complete patient recovery without sequelae.

Implications:

Meningoencephalitis should be considered in patients presenting with headache or febrile illness after endonasal DCR.
Early diagnosis and treatment are crucial for favorable outcomes.
This case highlights the importance of meticulous surgical technique in endonasal procedures.