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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.
Rhinology
|November 8, 2022
Summary
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.
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.
