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Posterior ischemic optic neuropathy following bilateral radical neck dissection
G A Schobel1, M Schmidbauer, W Millesi
1Department of Oral and Maxillofacial Surgery, University of Vienna, Austria.
International Journal of Oral and Maxillofacial Surgery
|August 1, 1995
Summary
Posterior ischemic optic neuropathy (PION) can occur after neck dissection due to low blood pressure. Histologic study revealed optic nerve damage, highlighting the need for preventative measures and monitoring.
Area of Science:
- Ophthalmology
- Neurology
- Surgical Complications
Background:
- Bilateral radical neck dissection is a complex surgical procedure.
- Posterior ischemic optic neuropathy (PION) is a rare but serious complication.
- Hemodynamic instability is a suspected cause of PION post-neck dissection.
Observation:
- A case study involving a patient who developed PION after bilateral radical neck dissection.
- Postmortem histologic examination of the optic nerve was conducted.
- Analysis focused on the pathogenic mechanisms leading to blindness.
Findings:
- PION in this case was likely multifactorial, involving hemodynamic hypotension.
- Histologic findings provided insights into the optic nerve's response to ischemic events.
- The study aimed to elucidate the specific pathways causing optic nerve damage.
Implications:
- Recommendations for preventing PION include staged surgical procedures.
- Avoiding drug-induced hypotension, overtransfusion, and anemia is crucial.
- Postoperative monitoring of visual acuity and patient head positioning are advised.