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Intraoperative intraorbital bleeding: considerations from a collaborative and retrospective Italian study with a

I Dallan¹, M Picariello¹, G Fiacchini¹

¹ENT Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

|November 8, 2022

Summary

This summary is machine-generated.

Intraoperative intraorbital bleeding requires prompt surgical intervention to prevent blindness. A new algorithm guides surgeons, with medial wall decompression and lateral canthotomy with inferior cantholysis (LCC) being key procedures.

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Area of Science:

Ophthalmology
Surgical Procedures
Emergency Medicine

Background:

Intraoperative intraorbital bleeding is a rare but severe complication.
Prompt management is crucial to prevent vision loss.
Surgical goals include rapid reduction of intraorbital pressure.

Purpose of the Study:

To propose a practical algorithm for managing intraoperative intraorbital bleeding.
To guide surgeons in critical intraorbital bleeding events.

Main Methods:

Multi-institutional retrospective study.
Analysis of intraoperative intraorbital bleeding cases requiring surgical management.
Exclusion of conservatively managed cases.

Main Results:

Sixteen cases analyzed; 12 underwent medial wall decompression, 4 had lateral canthotomy and inferior cantholysis (LCC).
Ten patients achieved full recovery.
Four patients experienced sequelae; two cases resulted in blindness.

Conclusions:

Timely surgical intervention is critical for managing intraorbital bleeding.
Lateral canthotomy and inferior cantholysis (LCC) offer rapid pressure reduction.
Medial orbital wall decompression is recommended as a first step if ethmoidectomy is complete in the operating room.