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Amaurosis Post-Bilateral Neck Dissection: A Systematic Review.

Jafar Hayat1, Yahya Ali2, Salman Hussain3

  • 1Department of Otolaryngology, Head and Neck Surgery, Jaber Al-Ahmad Al-Sabah Hospital, Kuwait, Kuwait.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|November 19, 2024
PubMed
Summary
This summary is machine-generated.

Amaurosis, or vision loss, can occur after bilateral radical neck dissections. This review highlights common causes like ischemic optic neuropathy and suggests a management algorithm due to limited evidence.

Keywords:
AmaurosisBilateral neck dissectionBlindnessRadical neck dissection

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Area of Science:

  • Ophthalmology
  • Otolaryngology
  • Neurosurgery

Background:

  • Bilateral radical neck dissection is a complex surgical procedure.
  • Amaurosis, or vision loss, is a rare but serious complication following this surgery.
  • Understanding the incidence and causes of amaurosis is crucial for patient outcomes.

Purpose of the Study:

  • To systematically review the literature on amaurosis following bilateral radical neck dissections.
  • To identify the prevalence, causes, and management strategies for post-operative amaurosis.
  • To propose a management algorithm to guide clinical practice and improve outcomes.

Main Methods:

  • Systematic literature review of PubMed, EMBASE, and Web of Science databases.
  • Inclusion of 23 articles reporting cases of amaurosis post-bilateral neck dissection from 1960-2021.
  • Descriptive analysis of study designs, patient demographics, surgical details, and management approaches.

Main Results:

  • 23 cases of amaurosis were reported, predominantly in case reports (n=21).
  • Common causes included posterior ischemic optic neuropathy (PION) and anterior ischemic optic neuropathy (AION).
  • Intraoperative hypotension and significant blood transfusion (mean 750 ml) were noted in several cases. High-dose corticosteroids were the most frequent management.

Conclusions:

  • There is a significant paucity of high-quality evidence regarding amaurosis post-bilateral neck dissection.
  • The review underscores the need for a structured management approach.
  • A proposed management algorithm can help standardize care and potentially mitigate this complication.